Payor-Partner Program Specialist- Remote

ProAct - PBM; City of Syracuse (NY); On-site; USD 25,000 - 30,000; Full time

Job summary

KPH Healthcare Services, Inc. seeks a patient services specialist to manage hub services relationships, enter medication orders, and provide exceptional customer support for patients and providers in a call center environment.

Responsibilities include serving as a primary contact for patients of designated payers, documenting information in TherigySTM and McKesson EnterpriseRX, and assisting in process improvement while ensuring accurate order processing and delivery.

Qualifications

• Knowledge of medications, physician orders, and pharmacy systems.
• Excellent communication and customer service abilities.
• Strong organization and multitasking capabilities.
• Proficiency with computers and keyboarding.

Responsibilities

• Assist in orienting and training new employees.
• Manage hub services relationships and enter medication orders.
• Serve as primary contact for patients of designated payers in a call center.
• Follow patient support models and programs to meet client expectations.
• Document information in TherigySTM and McKesson EnterpriseRX.
• Resolve customer service issues to ensure member satisfaction.
• Coordinate delivery of patient orders and set up shipping methods.

Skills

Pharmacy knowledge

Communication skills

Customer service

Organization

Multitasking

Typing/keyboarding

Education

High school diploma or GED

Pharmacy technician certification preferred

Job description

Scope of Responsibilities:

Works under general supervision. Follows standard procedures to accomplish assigned tasks. Assist in orienting and training employees

Job Summary:

Responsible for all aspects related to management of hub services relationships, entering of medication orders, and customer service for patients/providers in a call center environment.

• Provide direct support and serve as primary point of contact patients of designated third-party payers
• Follow customized patient support service models and programs to meet and exceed client expectations
• Follow established protocol and non-standard service models to provide the highest quality of services to patients
• Serve as subject matter experts on the intricacies of selected payer partner programs and assist patients in ensuring the correct triage and handling
• Responsible for assisting in the implementation of process improvement to ensure a streamlined patient relationship consistent with selected payer specifications. This may include accessing systems such as partner CRMs to investigate patient needs more fully.
• Responsible to receive triage patient calls from general call center for handling.
• Responsible for accurate selecting billing and shipping methods for incoming patient orders and setting up delivery of patient orders as necessary
• Customer service coverage for incoming calls and directing incoming calls to appropriate staff as needed
• Document patient reported information into TherigySTM
• Document and reporting information via McKesson EnterpriseRX
• Document and research plan specific information in partner CRM/tools.
• Provides resolution to customer service issues to ensure member satisfaction
• Work with members to provide resolution to payment related issues on accounts/orders
• Maintain and keep reasonable production as determined by supervisor
• May assist in orienting and training new employees
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Job Skill Requirements

• 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

Educational Requirements

• Minimum: High School Diploma or GED
• Preferred: Pharmacy technician or related certification

Experience

• Past experience in a customer service-related field
• Preferred: 12 months experience in a call center environment
• Preferred: 24 months experience as a pharmacy technician

Compensation

$18.50 - 22.00 per hour

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.