Solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing.
Ability to work in a fast paced environment, handling both inbound and outbound calls.
Must be organized, detail-oriented and able to document cases clearly and accurately in accordance with the program guidelines.
Good communication skills are essential, both internal and external.
Knowledge of Medicare benefits, enrollments and LIS assistance.
Plans and organizes work assignments, set priorities and completes work with a minimum of supervision.
Adheres to the service policy and principles of the company, as well as the program guidelines set by the department.
Participates in cross-training to perform all roles within the department.
Communicates effectively and professionally with our program partners to assure the best possible service for our patients and partners.
Other duties as assigned. Physical Demands: May sit, stand, stoop, bend and walk intermittently during the day.
May sit or stand seven (7) to ten (10) hours per day.
May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required.
May need to lift up to twenty-five (25) pounds on occasion.
Visual acuity to see and read fine prints.
Specific vision abilities required by this role include close vision, color vision and the ability to adjust focus. Must be able to hear normal voice sounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role.
Work Environment: Work in a climate-controlled, smoke-free internal environment.
Minimum (Required) Qualifications: (must be met in order to perform the job at the required level) Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence.
Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization Knowledge of Business Blocks and CPR+
Preferred Qualifications: Minimum of One (1) year work experience in applicant patient areas
Work with a team of specialists dedicated to one of our manufacturer partners to provide reimbursement support services.
Have direct interaction with the manufacturer client to provide case statuses and updates.
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