Program Specialist II
2 weeks ago
The Program Specialist II will provide dedicated support to patients and healthcare providers for activities related to benefit coverage, payments, reimbursements, denials, and general inquiry phone calls through our patient services support center.
Key Responsibilities:- Provide personalized support delivered over the phone and via online portal.
- Complete investigations and answer questions regarding insurance benefits, including information about coverage and out-of-pocket costs.
- Collaborate with patients and healthcare providers to assist with issues related to payments, reimbursements, payment denials, and appeals.
- Make outbound calls to customers for additional information.
- Assist with prior authorization and medical necessity processes, benefit verification, and prior authorization assistance.
- Administer comprehensive searches for alternate reimbursement resources, such as state and federal assistance programs, and enrollment assistance for qualified patients.
- Respond to inquiries from customers, sales representatives, and business partners, and follow up on requests in a timely, courteous, and professional manner.
- Maintain positive attitude and a helpful approach to customers and clients.
- Enter orders, change orders, track shipments, and enter customer notes to complete customer/consumer transactions.
- Process patient assistance applications according to business rules of program.
- High School Diploma and 4 years' experience or Associate's Degree and 2 years' experience in a healthcare setting.
- Excellent oral, written, and interpersonal communication skills.
- Ability to multi-task.
- Positive attitude.
- Accurate and detail-orientated.
- Ability to work independently and function as a team player.
- Ability to work in a fast-paced, metric-driven environment, while remaining patient-minded.
- Strong computer skills with a working knowledge of Microsoft Word, Excel, and PowerPoint.
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