Payor-Partner Program Specialist
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Job Description
Remote payer-partner specialist supporting pharmacy hub services, medication orders, and patient care for Noble Health Services. Managing payer programs, calls, billing, shipping, and customer resolutions.
Responsibilities:
- Provide direct support and serve as the primary point of contact for patients of designated third-party payers
- Follow customized patient support service models and programs
- Serve as a subject matter expert on selected payer partner programs and assist with patient triage and handling
- Assist with process improvement and investigate patient needs using partner CRMs
- Receive and handle triaged patient calls from the general call center
- Select accurate billing and shipping methods for incoming patient orders and arrange deliveries
- Provide customer service coverage and direct incoming calls to appropriate staff
- Document patient-reported information in TherigySTM
- Document and report information through McKesson EnterpriseRX
- Document and research plan-specific information in partner CRM/tools
- Resolve customer service and payment-related issues to ensure member satisfaction
- Maintain reasonable production levels as determined by the supervisor
- Assist in orienting and training new employees
- Complete mandatory and regulatory training programs
- Perform other duties as assigned
Requirements:
- High school diploma or GED required
- 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
- Past experience in a customer service-related field
- Preferred: 12 months of experience in a call center environment
- Preferred: 24 months of experience as a pharmacy technician
- Pharmacy technician or related certification preferred
Benefits:
- Assistance with orienting and training employees
- Mandatory and regulatory training programs
- Opportunity to participate in process improvement initiatives
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