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 :

Educational Requirements :

Experience :

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.