Patient Support Reimbursement Specialist

KellyConnect | Contact Center Solutions

Horsham (PA)

Remote

USD 20,264 - 24,659

Full time

14 days+

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Job summary

A leading contact center solutions provider seeks a Patient Support Reimbursement Specialist. The role involves assisting cancer patients with reimbursement processes. Candidates should have experience in a medical call center and possess strong communication and organizational skills. This full-time position is a remote opportunity, but residency within three hours of Horsham, PA, is required for occasional in-office attendance.

Qualifications

Minimum 3 years of relevant experience required, medical call center experience preferred.
Must be service-oriented and able to resolve patient/caregiver needs.
Demonstrate empathy and excellent communication skills.

Responsibilities

Perform reimbursement reconciliation activities for eligible patients.
Maintain Salesforce records to track progress on expense submissions.
Handle outbound calls to resolve discrepancies and request missing receipts.

Skills

Strong communication

Critical thinking

Organizational skills

Multi-tasking

Tools

Salesforce

Job description

Patient Support Reimbursement Specialist

Direct message the job poster from KellyConnect | Contact Center Solutions

The client organization is raising the bar on customer experience in the pharmaceutical industry. The Customer Service team supports eligible cancer patients and their caregivers through their CAR-T journey. They are deeply committed to providing patients/caregivers with an exceptional service experience, so they are well-positioned for treatment and to receive care.

The individual must be service-oriented and have the ability to anticipate and resolve patient/caregiver needs related to reimbursement. A successful candidate must have strong communication, critical thinking, and organizational skills, as well as the ability to multi-task and work across multiple technology platforms. The role represents a unique opportunity to assist patients/caregivers in close partnership with internal and external supplier partners.

Key responsibilities for this remote opportunity include, but are not limited to:

Perform out-of-pocket expense reimbursement reconciliation activities that support eligible patients and their caregivers through their MyCARVYKTI journey including:
Entering necessary patient and caregiver information and maintaining Salesforce records to continuously track progress throughout each expense submission
Cross-checking receipts against Expense Line Items to identify any expenses that do not have a corresponding receipt submitted by the patient and caregiver
Perform outbound calls to patients and caregivers to resolve discrepancies and request missing receipts, escalating to Patient Support Specialist if necessary
Reviewing and organizing expense receipts submitted by patients and caregivers and recording expense information for all itemized items including non-reimbursable items in Salesforce
Verifying final reimbursement amounts against expense limits
Managing reimbursement escalations and appeals with PSRS Supervisor
Completing the Reimbursement Expense Summary Report via Salesforce and emailing it to patient or caregiver following approval of the PSRS Supervisor
Managing check requests process in partnership with ConnectiveRX
Work collaboratively with the Patient Support Specialist (PSS) and Patient Support Eligibility Specialist (PSES) team to:
Ability to independently manage and support patient reimbursement cases located in your territory and support teammates when needed
Coordinate reimbursement reconciliation activities through systems to analyze and approve expenses
Reconcile any discrepancies between Expense Line Items and submitted receipts
Follow up and advocate until approval from PSRS Supervisor is received to secure reimbursements for patients/caregivers
Communicate ongoing issues that arise such as inconsistent or missing information and expense receipts with respective PSS, and recommend solutions that may include requesting additional materials from patients/caregivers
Maintain open line of communication with the PSRS Supervisor to monitor complex patient cases and expedite reimbursements that require a quick turnaround
Serve as call center back-up to Patient Support Eligibility Specialist team in helping to conduct eligibility assessments to ensure patients meet all requirements to participate in the MyCARVYKTI Program including:
Confirming travel benefits with the patient’s health insurance plan to avoid duplicative services to determine the program benefits that the patient and caregivers are eligible to receive
Support/triage inbound customer calls during high volume periods by:
Gathering relevant patient information and providing support and instructions when needed in place of PSS/PSES agents
Assisting patients/caregivers with less complex questions/needs (i.e. reimbursement, confirmation of travel dates, etc.)
Redirecting calls to appropriate agents or escalating cases to PSS/PSES Supervisors when needed
Triage calls to internal Innovative Medicine stakeholders when needed
Attend regular/ad-hoc meetings with the PSS/PSES team and leadership to summarize patient cases and discuss outstanding issues
Participate in quality control activities and continuous reimbursement process improvement initiatives
Monitor performance and help find operational and service offering improvements in the end-to-end patient experience
Support ad hoc administrative responsibilities and requests as directed by PSS leadership including:
Assisting with ongoing reimbursement workflow and efficiency improvement processes
Assisting with Salesforce user testing on enhanced reimbursement processes
Facilitating special research/projects related to MyCARVYKTI program materials
Support PSRS/PSS/PSES with new hire onboarding as needed
Proactively make recommendations to improve overall program performance
Identify gaps that need further support to improve customer experience

Qualifications:

A minimum of 3 years of relevant experience is required, pharmaceutical/medical call center experience preferred
Candidates must reside within a three-hour driving distance of Horsham, PA, as occasional in-office attendance will be required throughout the year.
Serve as a role model for best-in-class customer reimbursement support and contribute to a positive call center team environment
Reinforce patient/caregiver empathy throughout the call center team in the way you communicate with others
Support technology testing as needed
Ability to work efficiently in a remote work setting with excellent communication skills in a virtual environment
Troubleshoot and escalate issues to the PSS team as well as the PSRS supervisors to ensure timely reimbursement and complete satisfaction from patients and caregivers
Adherence to the current SOP is required, and escalations should be directed to your PSRS supervisor
Demonstrate a strong understanding and the importance of adhering to HIPAA-related policies when dealing with patient privacy throughout the entire process
Follow appropriate telephone etiquette when handling patient calls to maintain a compliant, positive, and empathetic relationship with patients and caregivers

About Kelly

Work changes everything. And at Kelly, we’re obsessed with where it can take you. To us, it’s about more than simply accepting your next job opportunity. It’s the fuel that powers every next step of your life. It’s the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly’s Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

Seniority level