The Reimbursement Specialist will be responsible for providing support and information about the insurance coverage of their prescribed Client medicines. They will accurately and efficiently find the patient's insurance coverage, and any other requirements by leveraging reimbursement tools and collaborating with payers and providers.
Share appropriate information with Patient Specialty Services field teams. This information may cover coverage-related queries from customers, provide pre-authorizations for medical treatment, and outline information regarding co-payments.
Must have strong communication skills to converse with payors and providers about benefits coverage and be able to offer solutions in accordance with approved procedures
Responsibilities :
Develop and maintain knowledge of PSS programs and payer coverage; broaden program knowledge over time.
Learn and utilize protocols, information and technology to gather patient coverage information. Some of this will be completed via phone calls to payers in a prompt and courteous manner.
Prepare proper documentation and notifications; perform proper escalation, tracking, and follow-up
Evolve skills to navigate the payer landscape regarding Client programs over time
As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Team Leads.
Education :
High School Diploma required
Required Experience :
6+ months of proven Reimbursement Experience (such as Healthcare, Payers or Pharmaceuticals)
Salesforce highly desired but not required
Experience and exposure in balancing multiple priorities with multiple audiences
Experience working with data entry system(s), fax machines, computer software, and telephone technology
Customer Call Center experience
Able to spend entire day on the phone. Prior experience working in hospital, clinic settings is a plus HCP and patient customer experience.
Computer literacy with email, video conferencing systems and data entry systems
Preferred Experience :
1 year of Reimbursement Specialist experience within a Customer Contact Center in the Pharmaceuticals industry
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Reimbursement Specialist • Tempe, AZ, United States
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