Clinical Care Coordinator

Software Methods, Incorporated; West Chester (Chester County); On-site; USD 42,000 - 60,000; Full time

Job summary

Software Methods, Incorporated is seeking a full-time Care Coordinator to join our team in Media, PA and West Chester, PA. The role centers on customer service and case coordination to help members access financial assistance programs.

You will follow up with members, pharmacies, healthcare providers and plan sponsors, document interactions in CRM, and support program enrollment while ensuring timely and accurate communications.

Qualifications

• Minimum 3+ years of customer service experience, preferably in healthcare reimbursement or pharmaceutical settings.
• Excellent written and verbal communication skills.
• Ability to multitask and manage a consistent workflow.
• Strong time management and prioritization abilities.
• Proficiency with computer, email and MS Office.

Responsibilities

• Ensure plan members meet eligibility requirements.
• Serve as primary contact for plan members and act as their advocate.
• Document/record all interactions in CRM in a timely manner.
• Provide exceptional customer service and resolve requests; escalate as needed.
• Coordinate access to patient assistance programs and assist with forms and applications.
• Verify drug dispenses and maintain audit trails.
• Communicate with health plans, PBMs, and sponsors as needed.
• Identify process improvements to optimize workflow.
• Perform other duties as assigned by management.

Skills

Customer service

Healthcare reimbursement

Pharmaceutical experience

Written communication

Oral communication

MS Office

Multitasking

Time management

Education

Medical Assistant Certification

Tools

CRM software

Job description

Our client is looking for a full-time Care Coordinators to join their team in their offices in Media, PA and in West Chester, PA.

The Care Coordinator is responsible for customer service and case coordination. This position will help plan members access financial assistance programs. The Care Coordinator will follow up with members, pharmacies, health care providers and/or financial assistance programs to confirm shipment/receipt of drug. From time to time, the Care Coordinator will be in contact with PBMs and Payers (Funds, Plan Sponsors, Insurers) to gather information and assist plan members.

Responsibilities:

• Ensure that plan members meet plan eligibility requirements
• Act as primary point of contact for plan members
• Serve as plan member advocate and enhance the collaborative relationship between the plan member, health care provider, and patient assistance program representatives
• Document/record all interactions with members, health care providers, pharmacies, and financial assistance entities in the Customer Relationship Manager software (“CRM”) in a timely manner
• Provide exceptional customer service to internal and external customers; resolve any customer requests in a timely and accurate manner; escalates complaints accordingly
• Review pending activities/events and specific customer requests to ensure excellent customer service and customer experience
• Demonstrate proficiency and full understanding of the Company plan member database including data elements, definition of case statuses and outcomes, case documentation requirements and the importance of meeting company metrics
• Research and identify available financial assistance programs for specialty drugs that are prescribed for active members
• Coordinate access to patient assistance programs; provide assistance to plan members and physician staff to complete all necessary financial assistance program forms and applications in a timely manner
• Coordinate delivery and verify receipt of financial assistance forms and applications to plan members, physician offices, and financial assistance programs
• Verify drug dispenses to members and compile audit trail of source documents and information for each dispense
• Report any financial assistance program trends to supervisor
• Communicate with plan member’s health plan sponsor, Fund, or PBM as needed
• Recommend improved processes and management methods to generate workflow optimization
• Perform such other duties as needed or assigned by management.

Requirements:

• Minimum 3+ years customer service experience, healthcare reimbursement and/or pharmaceutical experience preferred
• Excellent written and oral communication skills
• Ability to multi-task and handle consistent workflow
• Time management and prioritization skills
• Computer, email and MS Office competence.

Preferred skills:

• Medical Assistant Certification
• Bilingual communications

Unable to sponsor visas for this position.