[Remote] Remote - Payor-Partner Programs Specialist

Note: The job is a remote job and is open to candidates in USA. Noble Health Services is a multistate organization seeking a Payor-Partner Programs Specialist. The role involves managing hub services relationships, entering medication orders, and providing customer service for patients and providers in a call center environment.

Responsibilities

• 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
• May assist in training new employees

Skills

• 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
• Minimum: High School Diploma or GED
• Past experience in a customer service-related field
• Pharmacy technician or related certification
• 6 months experience in a call center environment
• 12 months experience as a pharmacy technician

Company Overview