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Remote - Payor-Partner Programs Specialist

Overview:

Scope of Responsibilities: Works under general supervision. Follows standard procedures to accomplish assigned tasks. Assist in orienting and training employees

Job Summary: Responsible for all aspects related to management of hub services relationships, entering of medication orders, and customer service for patients/providers in a call center environment.

Responsibilities:

Provide direct support and serve as primary point of contact patients of designated third-party payers
Follow customized patient support service models and programs to meet and exceed client expectations
Follow established protocol and non-standard service models to provide the highest quality of services to patients
Serve as subject matter experts on the intricacies of selected payer partner programs and assist patients in ensuring the correct triage and handling
Responsible for assisting in the implementation of process improvement to ensure a streamlined patient relationship consistent with selected payer specifications. This may include accessing systems such as partner CRMs to investigate patient needs more fully.
Responsible to receive triage patient calls from general call center for handling.
Responsible for accurate selecting billing and shipping methods for incoming patient orders and setting up delivery of patient orders as necessary
Customer service coverage for incoming calls and directing incoming calls to appropriate staff as needed
Document patient reported information into TherigySTM
Document and reporting information via McKesson EnterpriseRX
Document and research plan specific information in partner CRM/tools.
Provides resolution to customer service issues to ensure member satisfaction
Work with members to provide resolution to payment related issues on accounts/orders
Maintain and keep reasonable production as determined by supervisor
May assist in orienting and training new employees
Responsible for completing all mandatory and regulatory training programs
Perform other duties as assigned
May assist in training new employees

Qualifications:

Job Skill Requirements:

Broad knowledge of medications, physician orders, and pharmacy systems
Effective communication skills
Outstanding customer service skills
Excellent organization skills
Ability to multitask and prioritize
Excellent computer and keyboarding skills

Educational Requirements:

Minimum: High School Diploma or GED
Preferred: Pharmacy technician or related certification

Experience:

Past experience in a customer service-related field
Preferred: 6 months experience in a call center environment
Preferred: 12 months experience as a pharmacy technician

Compensation

$18.50 - 22.00 per hour

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.

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