Program Specialist

Role & responsibilities

Role: Program Specialist (Non-Voice Process)

About the Role

The Program Specialist is responsible for serving as the customers primary point of contact providing operational and reimbursement support to complex programs , including but not limited to, marketing support, reimbursement hotlines, patient assistance programs, Hubs, foundations, safety surveillance programs, case management, and compliance programs.

Key Responsibilities:

• Quickly and efficiently respond to incoming faxes, identify how best to assist.
• Document fax in appropriate tracking systems, and handle/escalate 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 tasks 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. use 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 marketplace and the insurance options available for patients. Educate patients on the available options as appropriate.
• Strict adherence to follow the process SOPs

Key Responsibilities

• Insurance

  Verification:

  Confirming if a patient's prescribed medication is covered by their insurance.

• Data

  Entry:

  Documenting call information and patient data in tracking systems. (Patients Enrolment, Verification and Patient Care program)

• Patient

  Enrollment:

  Verifying patient eligibility and accepting or denying enrollment based on form information.

• Reverification

  : Periodically checking patient eligibility to maintain accurate records.

Experience:

1.6 or more years

experience in handling sensitive data in US healthcare with high degree of proficiency.

Must be familiar with HIPAA guidelines.

Education:

The Program Specialist ideally will hold a bachelors degree or a masters 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 high degree of accuracy while handling/processing sensitive data.
• Be motivated to ensure timely processing of work 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 meet deadlines.
• Express thoughts and instructions clearly in both oral and written communication, i.e. use 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.

Shift:

Transportation:

Night

Contract Duration:

Work

Location

Preferred candidate profile

Must be from Bangalore

Must be comfortable working in US shift and form office

Have strong knowledge of US Healthcare and US Insurance policies.

Good communication