Escalations Specialist
Found in: Resume Library US A2 - 2 weeks ago
Through innovation, technology, and unparalleled customer service, TrialCard’s passionate people provide patient-centric solutions to the pharmaceutical industry that improve access, affordability, and adherence to enhance patients’ lives. We work tirelessly on the behalf of our clients, because when they succeed, so do we.
That’s not to say we are all work and no play. TrialCard is an open workplace with fun, energetic people united for a common purpose. In fact, we don’t even refer to each other as employees. We’re team members. We foster a culture that encourages individual personality.
The Escalations Specialist – Pharmacy Benefit will facilitate a collaborative process that gauges, implements, coordinates, monitors, and evaluates the affordability services of pharmacy benefits, provided on behalf of a manufacturer. The primary function is to provide unparalleled customer service to patients, pharmacies, and manufacturer partners as a dedicated patient affordability liaison by coordinating resources, exchanging information, and ensuring appropriate delivery of services.
Responsibilities:
Monitors and actions escalations related to the day-to-day activities of assigned pharmacy benefit patient affordability programs
Assists internal and external stakeholder by acting as an advocate, navigator for delivering detailed information regarding a program(s) and/or a patient(s), and serves as focal point for investigations and escalations
Conduct outreach, verbal and written, to internal and external stakeholders associated with the supported programs
Provides unparalleled customer service while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commit to the appropriate use of resources
Consistently exercises discretion and judgment to analyze, interpret, make deductions and then decide what actions are necessary based on the varying facts and circumstances of the program
Provide Production Support for investigations, inquiries, and escalations to review, evaluate, action, and respond to ticket submissions for assigned program(s)
Have a complete understanding of the service processes and supporting systems to be able to investigate scenarios and determine a resolution
Improve patient outcomes through advocacy, communication, education and facilitation of services
Maintains a high level of ethical conduct regarding confidentiality and privacy
Maintains records in accordance with applicable standards and regulations to the programs/promotions
Evaluates programs/promotions to identify opportunities to address issues/gaps at the root cause
Participates in program/promotion centered team meetings and improvement/enhancement initiatives both current and future
Works with internal stakeholders as needed and properly document, escalate, and address issues
Participates in continuing education activities to remain knowledgeable in all programs/promotions and other related areas
Other responsibilities as assigned
Qualifications:
Associate or Bachelor’s degree preferred; or a minimum of 5 years of customer service experience with progressive levels of responsibility within a service driven environment
Strong understanding of pharmacy claims processing, rejection troubleshooting, and claims workflows a plus
Ability to provide very articulate verbal and written communication
Directly supporting and liaising between the client facing teams and technology and operational delivery teams
MS Excel skills with the ability to review data sets to conclude outcome
Ability to manage and prioritize workload based on competing demands
Customer Service – ability to collaborate with users to articulate requests, issues and resolution on time and within budget
Proven problem-solving abilities
Logical and efficient with keen attention to detail and committed follow through in communication with patients, providers, and internal stakeholders
Strong organizational skills
Willing to work in a dynamic, fast paced environment and can multi-task
Empathetic listening skills to interact effectively with all program stakeholders
Strong customer service experience and skills
Strong interpersonal skills, ability to work both independently and as part of a team
Proficient with Microsoft products
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