Program Specialist

Role: Program Specialist (Voice Process)

Key Responsibilities:

• Quickly and efficiently respond to incoming calls and faxes, identify how best to assist.
• Conduct outbound calls of insurance verifications to understand if patients prescribed therapy is eligible for coverage. Document results in appropriate tracking system.
• Document calls in appropriate tracking systems, and handle/escalate calls per established procedures.
• Process patient applications and follow the program's specifications to determine their eligibility. Document results in appropriate tracking system and manage follow-ups as appropriate. Place follow-up calls and respond to enquiries from patients and/or healthcare providers as necessary.
• Maintain a professional, calm and friendly demeanor. Express thoughts and instructions clearly in both verbal and written communication; i.e. uses grammatically correct and concise language.
• Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate.
• Be familiar with the market place and the insurance options available for patients. Educate patients on the available options as appropriate.
• Strict adherence to follow the process SOPs

Minimum Requirement:

• Experience:

The Program Specialist ideally should have two or more years of prior customer service, volunteering, or other customer-facing experience. Prior experience in the US healthcare industry is a must , and the Program Specialist must be a proven problem solver with the ability, drive, and initiative to learn the required healthcare, reimbursement, and customer service skills necessary to support the assigned program(s). Experience in handling sensitive data in US healthcare with high degree of proficiency. Must be familiar with HIPAA guidelines. Candidates should be flexible in working from home or in an office setting per business needs.

• Education:

The Program Specialist ideally will hold a bachelors degree or a Master’s Degree with all Documents from a regular College/University.

The Program Specialist should:

• Proficient in English, verbal and written
• Easily navigate between multiple computer programs with dexterity
• Adheres to schedule and meets deadlines.
• Demonstrate solid customer service skills.
• Understand each customer’s needs and tailors responses with those needs in mind
• Express empathy while speaking with customers.
• Be motivated to help customers every day and operate with a sense of accountability and urgency.
• Thrive working in a very scheduled and collaborative work environment while also being able to work independently.
• Adhere to schedule and meets deadlines.
• Express thoughts and instructions clearly in both oral and written communication; i.e. uses grammatically correct, concise language.
• Pay close attention to detail and consistently be a keen problem solver.
• Adapt to changes and properly anticipate the next process steps when faced with ambiguous scenarios.
• Learn information quickly, retain it, and effectively work on multiple tasks simultaneously

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