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Healthcare Enrollment Consultant

2 months ago

Louisville, Kentucky, United States Nesco Resource Full time

The Patient Enrollment Specialist plays a crucial role in facilitating the annual enrollment process for patients seeking coverage for their prescribed medications. This position involves providing support through both inbound and outbound calls, alongside various administrative tasks. It is a seasonal role within a call center environment, offering flexible scheduling. Training and work will be conducted onsite. Typical work hours span from 8 AM to 8 PM, Monday through Friday.


Key Responsibilities:
  • Evaluate and process patient enrollment applications for the Patient Assistance Program (PAP).
  • Assist patients via phone in navigating the PAP program enrollment by confirming pre-screening and qualification criteria.
  • Inform patients and healthcare providers regarding approvals, denials, and necessary next steps to advance the enrollment process.
  • Coordinate the scheduling of treatments to be delivered to patients or their healthcare providers.
  • Manage inbound and outbound communication lines for the PAP program.
  • Engage daily with patients or their authorized representatives to discuss eligibility based on PAP standards and collaborate with healthcare providers to set expectations.
  • Reach out to patients or their representatives to gather additional information required for enrollment in the manufacturer's PAP.
  • Prioritize tasks to ensure timely processing of patient enrollments.
  • Clearly explain the PAP program and its services to patients, authorized representatives, healthcare providers, and medical office staff.
  • Address inquiries from patients, authorized representatives, healthcare providers, patient advocates, and caregivers regarding the program.
  • Document any adverse events or product complaints in accordance with established operating procedures and best practices.
  • Execute daily operations related to assigned programs.
  • Uphold patient confidentiality at all times.

Qualifications:
Required Education and Experience:
  • High school diploma or equivalent.
  • Demonstrated ability to deliver consistently high-quality service.
Preferred Education and Experience:
  • Experience working through the project duration.
  • Familiarity with insurance and benefit investigations; knowledge of U.S. private and government payers.
  • Two years of experience in pharmacy, managed care, Medicaid, Medicare, pharmaceutical or biotech industries, insurance, medical offices, or related fields.
  • Six months of experience in a call center setting.
  • Knowledge of HIPAA regulations and patient services.
  • Fluency in both English and Spanish is a plus.
Knowledge, Skills & Abilities:
  • Exhibit empathy and compassion in interactions.
  • Possess excellent verbal and written communication skills.
  • Demonstrate strong organizational skills and attention to detail.
  • Effectively manage multiple priorities to meet response deadlines.
  • Show adaptability and flexibility in changing situations.
  • Work independently as well as collaboratively within a team.
  • Utilize basic math principles effectively.
  • Apply logical reasoning to evaluate practical problems.
  • Present information clearly and respond to stakeholder inquiries.
  • Engage with a diverse group of individuals.
  • Exhibit strong listening skills and empathy.
  • Demonstrate proficiency in Microsoft Word, Excel, and Outlook.
  • Handle challenging situations with tact and diplomacy.
  • Show sensitivity and understanding when communicating with patients.
  • Display enthusiasm for engaging with people.

Nesco Resource is committed to providing equal employment opportunities to all employees and applicants, prohibiting discrimination and harassment of any kind without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.