Program Specialist

Role & responsibilities

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. 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

Other duties as assigned

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.

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 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. Candidate 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 Masters Degree with all Documents from a regular College/University.