Program Specialist

Role & responsibilities

• Promptly respond to incoming calls and faxes, assess needs, and provide appropriate assistance.
• Conduct outbound insurance verification calls to confirm coverage eligibility for prescribed therapies; document outcomes in tracking systems.
• Accurately log all call interactions and escalate issues per established procedures.
• Process patient applications, determine eligibility per program guidelines, and manage follow-ups including outbound calls and inquiries.
• Maintain a calm, professional, and friendly demeanor; communicate clearly and effectively in both verbal and written formats.
• Coordinate prescription orders and transfers to specialty pharmacies based on urgency.
• Stay informed about insurance options and educate patients on available coverage solutions.
• Ensure strict adherence to SOPs and maintain high standards of process compliance.