Payor-Partner Program Specialist- Remote

Summary

Job TitleResponsible 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.ResponsibilitiesProvide direct support and serve as primary point of contact for 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.QualificationsBroad 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.Minimum: High School Diploma or GED. Preferred: Pharmacy technician or related certification.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.$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.

Job Description

Job TitleResponsible 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.ResponsibilitiesProvide direct support and serve as primary point of contact for 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.QualificationsBroad 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.Minimum: High School Diploma or GED. Preferred: Pharmacy technician or related certification.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.$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.