Program Specialist - Voice Support

Role & responsibilities

• Insurance Verification

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

• Prior Authorizations:

  Coordinating with insurance providers to obtain prior authorizations for specific medications.

• Patient Assistance:

  Helping patients navigate insurance complexities, including coordinating prior authorizations and investigating alternative coverage options.

• Alternative Funding:

  Investigating other funding sources for medications if insurance coverage is inadequate.

• Product Coordination:

  Liaising with distributors and manufacturers to request and track medications.

• Prescription Management:

  Coordinating prescription orders and transfers to specialty pharmacies.

• Data Entry:

  Documenting call information and patient data in tracking systems.

• Communication:

  Liaising with patients, healthcare providers, and pharmaceutical manufacturers.

• Training:

  Assisting in training new team members.

Essential Job Duties:

• Document calls in appropriate tracking systems, and handle/escalate calls per established procedures.
• Conduct insurance verifications to understand if patients prescribed therapy is eligible for coverage. Possibly coordinate prior authorizations, investigate alternative insurance coverage, or other funding sources on behalf of the patients per the program specifications.
• Process patient applications of various complexities and follow the programs specifications to determine their eligibility. Place follow up calls and respond to enquiries from patients and/or healthcare providers as necessary.
• Liaise with partner distributors and pharmaceutical manufacturers to request products per the programs guidelines and track shipments.
• 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.
• Assist with training new team members by shadowing/reverse shadowing them and serving as a data checker by reviewing data entered in the program’s tracking system.

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

Preferred candidate profile

• 2 year minimum International Voice Process
• Insurance benefits verification experience
• Experience working remotely
• Computer/technology experience
• Strong communication skills