Payor-Partner Program Specialist- Remote

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 : 12 months experience in a call center environment

Preferred : 24 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.