Referral Support Specialist

5 days ago


Pittsburgh, Pennsylvania, United States Free Market Health Full time
Job Description

Overview

At Free Market Health, we are seeking a highly skilled Referral Support Specialist to join our team. As a Referral Support Specialist, you will play a critical role in ensuring seamless patient onboarding and referral management processes.

Key Responsibilities

  • Referral Oversight
    • Provide primary oversight of referrals to ensure timely member onboarding by the assigned pharmacy.
  • Referral Monitoring
    • Continued referral monitoring for timely refills, therapy abandonment/discontinuation, multiple referrals for associated products, and multiple referrals under different member IDs.
  • Eligibility Verification
    • Review eligibility files for eligibility verification/reverification through referral lifecycle and unmanage referrals as appropriate.
  • Issue Escalation
    • Escalate issues to specialized teams and support teams as required.
  • Customer Support
    • Identify and notify Customer Success when opportunities for additional education/training are noticed while supporting pharmacies.
  • Technical Skills
    • Work within all applications needed to perform job duties.

Qualifications

  • Education
    • High School diploma or equivalent GED.
  • Experience
    • 1 year of work experience.
  • Skills
    • Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
    • Good verbal and written communication and interpersonal skills with the ability to communicate in a diplomatic and confidential manner.
    • BASIC knowledge of and skills using MS Windows, MS Office Suite and/or other similar operating/software programs.
    • Ability to understand and follow instructions, work independently and efficiently.

Preferred Qualifications

  • Experience
    • Customer service experience in a healthcare, specialty pharmacy, PBM, call center setting or other related industry.
  • Skills
    • Proficient computer skills with ability to learn proprietary company software.
    • Experience working with multiple systems with flexibility and the ability to multitask.

Benefits

  • Comprehensive healthcare coverage, including medical, dental, vision.
  • Paid holidays and unlimited paid time off.
  • 401(k) savings plan with company match.


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