Hybrid Care Coordination & Patient Benefits Specialist

TEKsystems; Morrisville (NC); Hybrid; USD 30,000 - 33,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Time Off

Job summary

TEKsystems in Morrisville, NC is seeking a Care Coordinator to provide inbound and outbound phone support, coordinating patient benefits, orders, and appointments for a manufacturer’s Patient Support Program. You will be the primary contact for payers, patients, caregivers, and providers, delivering exceptional service and ensuring timely delivery of services.

The role requires knowledge of payer types, prior authorization, and appeals, with strong communication skills and experience in health

Qualifications

• : Associate or bachelor’s degree and 2 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing preferred, or in lieu of a degree, a High School diploma or equivalent with 5 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing
• :

Responsibilities

• Care Coordinator may be regionally aligned and will serve as an expert on all aspects of benefit coordination, and other forms of available support and will be responsible for handling healthcare provider and/or patient interactions
• May serve as an advocate to patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy
• Establishes relationships, develop trust, and maintain rapport with healthcare providers and/or patients
• Serves as point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
• Strong working knowledge and ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B
• Navigates through payer challenges by asking appropriate questions to obtain the necessary result
• Acts as an assigned liaison to client contacts (e.g., regional contact for sales representatives)
• Maintains records in accordance with applicable standards and regulations to the programs/promotion
• Follows program guidelines and escalates complex cases according to SOPs, Call Guides, and other program materials.
• Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events, safety complaints as per program SOPs) – (specific to program/client requirements) through Inbound and Outbound calling
• Liaison between Program Management, other internal stakeholders, and healthcare providers
• Provides unparalleled customer service, with attention to detail, while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commits to the appropriate use of resources
• Works with all levels of Program Management on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction, coordination challenges and program effectiveness
• Understands the nature of the disease states of patients of the program

Skills

customer support

insurance coverage

call center

insurance verification

crm

Education

Associate or Bachelor’s degree

High School diploma with 5 years experience

Tools

Microsoft Office

Job description

TEKsystems in Morrisville, NC is seeking a Care Coordinator to provide inbound and outbound phone support, coordinating patient benefits, orders, and appointments for a manufacturer’s Patient Support Program. You will be the primary contact for payers, patients, caregivers, and providers, delivering exceptional service and ensuring timely delivery of services.

The role requires knowledge of payer types, prior authorization, and appeals, with strong communication skills and experience in health