Biotech and Pharmaceutical, Broadband, C Programming Language, Case Management, Computer Skills, Corporate Policies, Customer Relations, Customer Support/Service, DSL (Digital Subscriber Line), Data Entry, Disease, Documentation, Drug Manufacturing, Emerging Technology, Healthcare Providers, Healthcare Reimbursement, High School Diploma, Insurance, Interpersonal Skills, Managed Care, Medicaid, Medicare, Medicare Reimbursement, Medications, Microsoft Office, Onboarding, Organizational Skills, Patient Care, People Management, Pharmacy, Prescription Drugs, Presentation/Verbal Skills, Problem Solving Skills, Procedure Development, Process Development, Purchasing/Procurement, Technical Support, Telephone Skills, Time Management, Wi-Fi, Work From Home, Writing Skills
Senior Coordinator, Patient Access (Case Manager)
Cardinal Health SonexusTM Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions driving brand and patient markers of success. We re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.
Together, we can get life-changing therapies to patients who need them faster.
Responsibilities:
Receive inbound and outbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution
Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience
Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services
Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes
Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed
Resolve patient's questions and any representative for the patient s concerns regarding status of their request for assistance
Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products
Process enrollments via fax, phone, and electronically as needed
Scrutinize forms and supporting documentation thoroughly for any missing information or new information to be added to the database
Qualifications:
2-4 years of industry experience with patient-facing or high touch customer interaction experience preferred
Previous Hub or Patient Support Service experience preferred
High School diploma or equivalent preferred
Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred
Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust.
Robust computer literacy skills including data entry and MS Office-based software programs
Strong understanding of pharmaceutical therapies, disease states, and medication adherence challenges preferred
Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers
What is expected of you and others at this level:
Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
In-depth knowledge in technical or specialty area
Applies advanced skills to resolve complex problems independently
May modify process to resolve situations
Works independently within established procedures; may receive general guidance on new assignments
May provide general guidance or technical assistance to less experienced team members
TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 8:00pm CST.
REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.
Download speed of 15Mbps (megabyte per second)
Upload speed of 5Mbps (megabyte per second)
Ping Rate Maximum of 30ms (milliseconds)
Hardwired to the router
Surge protector with Network Line Protection for CAH issued equipment