Patient Experience & Access Specialist

Valeris; Springfield (IL); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Life and AD&D coverage

401(k) with company match

Paid time off & holidays

Job summary

Valeris is seeking a dedicated Patient Services professional to support patients in navigating benefits, coverage, and treatment options. You will communicate clearly, manage enrollments, and coordinate with providers to ensure timely services.

This full-time role requires an 8.5-hour shift, flexibility, and bilingual abilities. The company offers comprehensive benefits and a strong focus on patient care and support across the healthcare value chain.

Qualifications

• Bachelor's degree strongly preferred or equivalent experience.
• Customer service and healthcare industry experience preferred.
• Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday.
• Bi-lingual in English and Spanish or Chinese/Mandarin is a plus.
• Commitment to the mission of care coordination.
• Good communication and interpersonal skills and ability to speak concisely to patients.
• Flexible and adaptable to changing patient and healthcare providers' needs.
• Professional telephone etiquette.
• Basic computer knowledge and ability to multitask.

Responsibilities

• Build and maintain trusted relationships with patients by demonstrating proactive communication, delivering timely and accurate services, and showing a strong commitment to patient well-being.
• Ensure all interactions and relationship management practices comply with relevant healthcare laws and regulations.
• Demonstrate prior experience working with pharmacy benefit products and patients, or in immunology practices, to better understand patient needs and concerns.
• Conduct program welcome calls to patients, engaging them effectively and explaining available services and resources for their support.
• Utilize motivational interviewing techniques to actively involve patients in goal setting and achieving their healthcare objectives.
• Perform post Benefits Investigation calls to patients, clearly explaining coverage options to enhance patient understanding.
• Effectively handle all client inquiries that cannot be resolved through standard reporting processes.
• Address patient inquiries in accordance with applicable business rules, providing accurate and helpful information.
• Articulate complex reimbursement and billing information in a clear and concise manner to ensure patients comprehend their coverage benefits and financial responsibilities.
• Handle inbound calls as per the program-approved Frequently Asked Questions (FAQs).
• Exhibit excellent customer service skills, even in a fast-paced environment, and de-escalate any challenging situations in a professional and appropriate manner.
• Triage patients to appropriate internal or external resources, depending on their needs and requirements.
• Ensure proper documentation and recording of patient enrollment into the program, following established business rules.
• Provide patients with comprehensive information and education about products, including the course of treatment, insurance coverage benefits, anticipated out-of-pocket costs, potential financial assistance resources, and ongoing treatment support.
• Proactively manage assigned cases and tasks to maintain service levels and deliver excellent customer service to patients.
• Empower and inspire patients to take charge of their therapy plan as prescribed by their healthcare provider.
• Leverage electronic tools to identify benefits and payer coverage, conducting manual benefit investigations when necessary.
• Identify and communicate patients' plan benefit coverage, including any prior authorization, appeal, tier exception, or formulary exclusion requirements.
• Utilize electronic resources to obtain benefit coverage outcomes, and if needed, conduct outbound calls to payers and healthcare providers for follow-up.
• Support adherence services through the coordination of nurse follow-up, as applicable to the program.
• Identify and recommend peer support resources for patients to enhance their treatment experience.
• Coordinate the shipment of products through patient assistance programs and/or bridge programs from the PharmaCord pharmacy.
• Proactively communicate the need for re-verification of prior authorization or re-enrollment for patient assistance programs.
• Report adverse events, product complaints, special situation reports, and medical inquiries in accordance with established SOPs and Business Rules.
• Document all activities within the Lynk system to maintain accurate and up-to-date records, adhering to business requirements.

Skills

Customer service

Healthcare industry experience

Communication skills

Multitasking

Emotional intelligence

Education

Bachelor's degree

Job description

Valeris is seeking a dedicated Patient Services professional to support patients in navigating benefits, coverage, and treatment options. You will communicate clearly, manage enrollments, and coordinate with providers to ensure timely services.

This full-time role requires an 8.5-hour shift, flexibility, and bilingual abilities. The company offers comprehensive benefits and a strong focus on patient care and support across the healthcare value chain.