Patient Services Associate
28 days ago
Jeffersonville
Job Description This opportunity is a full-time on-site position in Jeffersonville, IN. When you join the team as the Patient Services Associate, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process to getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely. A typical day in this role will include ownership of your patients cases from initiation to closure to include; benefit investigations, prior authorizations / denial appeals, determining financial qualifications for assistance programs and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology) by using your critical thinking skills and your knowledge of the program and industry rules and standards. This role requires a high level of ownership, attention to detail and patient focus and will put your problem-solving skills to the test! A typical day in the life of a Patient Services Associate will include the following: The responsibilities include, but are not limited to the following: • Relationship Management, • Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients, • Manages all relationships in a manner that adheres to healthcare laws and regulations, • Benefit Verification:, • Performing patient level benefits verifications as applicable for all major medical and pharmacy benefits plans., • Completion of the template forms that provide patient level benefits Coverage Determination Summary., • Coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance., • Patient Assistance:, • Review of patient assistance enrollment forms and any supporting documentation to assess patient eligibility for participation as per SOPs and program guidelines., • Determination of patient’s eligibility based upon program criteria for qualification., • Communicating the patient’s eligibility to the patient, healthcare provider, and/or consignment pharmacy., • Communications, • Performs program welcome calls to patients, • Performs post Benefits Investigation calls to patients and physicians explaining coverage options, • Manages all client inquiries unable to be determined by client through reporting, • Manages HCP inquiries, as applicable, pursuant to business rules, • Inbound Call Management, • Manages inbound calls as directed by the program-approved FAQs, • Triage patients to internal or external resources as appropriate, • Personalized Case Management, • Provides personalized case management to patients and HCPs including outbound communication to HCPs and patients to communicate benefit coverage and next steps in obtaining coverage, • Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed, • Identifies and communicates patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions, • Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome, • Coordinates nurse teach with field-based nurse educators, as applicable to program, • Supports adherence services through coordination of nurse follow up, as applicable to program, • Identifies peer support resources for patients, • Coordinates shipment of product through patient assistance program and/or bridge program from the PharmaCord pharmacy, • Proactively communicates needs for reverification of prior authorization or re-enrollment for patient assistance program, • Reports adverse events, Product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and the Business Rules, • Documents all activities within the PharmaCord Link system in accordance with business requirements, • Answer and assist inbound callers through resolution utilizing answers to frequently asked questions or by warm transferring callers to other appropriate individuals., • Actively listen to each customer, assess needs, and respond with demonstrated patience and courtesy., • Review and identification of information that is missing and/or incorrect within program service requests/program applications., • Reporting of Adverse Events/ Product Complaint inquiries received in accordance with SOP and good manufacturer practices., • Provides timely feedback to the company regarding service failures or customer concerns, • Effectively uses our internal technology platform, Link, to complete claims processing and keep workflows moving., • Communicate with key medical practice accounts, sales representatives regarding the status of cases. Provide consultative services where issues arise on how obstacles can be overcome to get patient on paid therapy. Successful candidates possess the following personal attributes: • Detail oriented, • Service minded; focus on recognizing and meeting the needs of others (especially patients and care partners), • Ability to handle personal health information with confidentiality, • Commitment to honesty and integrity, • Accountability for results, • Professional telephone etiquette, • Self-awareness of your own emotions and the potential impact on others, • Basic computer knowledge, • Ability to multitask effectively, • Ability to recognize emotions and their effects, • Sureness about self-worth and capabilities, • Manage disruptive impulses, • Maintain standards of honesty and integrity, • Takes responsibility for performance, • Adapts and handles change with flexibility, • Is innovative and open to new ideas, • Achievement driven; constant striving to improve or to meet a standard of excellence, • Aligns with the goals of the group or organization, • Ready to take initiative and act on opportunities, • Be optimistic and pursue goals persistently despite obstacles and setbacks, • Be service oriented and anticipate, recognize and meet needs of others, including patients and care partners, • Clear and concise communication, • Bachelor's degree strongly preferred or equivalent experience required; completion of a high school diploma or GED is required, • Customer service and healthcare industry experience strongly preferred, • Ability to work an 8.5-hour shift between 8 am to 11 pm, Monday to Friday required, • Bi-lingual in English and Spanish or Chinese/Mandarin is a plus, • All employees working onsite in a PharmaCord facility are strongly encouraged to be vaccinated against COVID-19, • While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy., • Although very minimal, flexibility to travel as needed is preferred., • This position requires ability to work a standard 8.5-hour standard shifts between our business operating hours of 8am - 8pm Monday through Friday. A shift will be assigned and may change depending on business need., • This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc., • Company paid Short-term Disability (STD), • Increased competitive 401(k) company match up to 4%, • Affordable Medical, Dental, and Vision benefits - PharmaCord covers 75% of Medical Premiums for our employees, • PharmaCord has not increased healthcare premiums in the past 4 years, • Concierge Medical Clinic free of cost for those enrolled in a PharmaCord medical plan (including dependents), • Wellness discounts of up to $260 per year for participation in wellness program, • Annual HSA employer contribution, • Company paid and voluntary Life Insurance options, • Voluntary Life, AD&D and Long-Term Disability Insurances, • Paid Parental Leave of Absence, • Wellness and Employee Assistance Programs, • PTO benefits, flex days and paid holidays, • Employee Referral Program, • Ambassador Program, • Competitive starting pay rates, • Toll reimbursement program (valued at $678.60 per year), • Working for PharmaCord - voted Best Places to Work in Kentucky for 2019 and 2021, • Work for a company that values diversity and makes deliberate efforts to create in inclusive workplace, • Opportunities for advancement with a company that supports personal and professional growth, • A challenging, stimulating work environment that encourages new ideas, • Exposure to many learning and development opportunities, • Playing a crucial part in the lives of our patients, physicians, and pharmacies by enhancing the patient services experience At PharmaCord, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer. In order to maintain a safe workplace for our team members, PharmaCord strongly encourages that all employees are vaccinated against COVID-19. PharmaCord is unable to sponsor employees at this time. Want to learn more about us? Find us on LinkedIn, Glassdoor, Twitter & Facebook! Company DescriptionOur Company: PharmaCord is a leading provider in pharmaceutical patient support services. Our services are sponsored by our pharmaceutical company clients. Together, we are committed to compassionately providing patients with support services during their journey on therapy. We deliver our services through our talented team of benefit specialists, nurses, pharmacists, case managers, pharmacy techs, program managers, and other incredibly talented team members who are supported by world-class proprietary technology systems developed in house by our team of engineers, system architects, coding professionals and data scientists. We are PharmaCord, a purpose-driven organization on a rapid growth journey. Our Team: Our team is highly motivated and passionate about providing the highest quality customer support to our patients. We look for individuals interested in growing with our company and working in an exciting, open and collegial work environment. We seek problem solvers who are compassionate, have high integrity and demonstrate grit. Our colleagues are enthusiastic team members who love what they do and are passionate about making a difference through their work. We take initiative, exhibit pride in our accomplishments, and are trusted to work independently while collaborating to share ideas, support, and resources.Our Company: PharmaCord is a leading provider in pharmaceutical patient support services. Our services are sponsored by our pharmaceutical company clients. Together, we are committed to compassionately providing patients with support services during their journey on therapy.\r\n\r\nWe deliver our services through our talented team of benefit specialists, nurses, pharmacists, case managers, pharmacy techs, program managers, and other incredibly talented team members who are supported by world-class proprietary technology systems developed in house by our team of engineers, system architects, coding professionals and data scientists.\r\n\r\nWe are PharmaCord, a purpose-driven organization on a rapid growth journey.\r\n\r\nOur Team: Our team is highly motivated and passionate about providing the highest quality customer support to our patients. We look for individuals interested in growing with our company and working in an exciting, open and collegial work environment. We seek problem solvers who are compassionate, have high integrity and demonstrate grit. Our colleagues are enthusiastic team members who love what they do and are passionate about making a difference through their work. We take initiative, exhibit pride in our accomplishments, and are trusted to work independently while collaborating to share ideas, support, and resources.
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