Position Summary:
Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or appeal status.
The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned.
This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.
Care Manager
As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma gettheir medicinestothe people who need them. We help customers gain insight and access to their markets andultimately demonstratetheirproduct’svalue to payers,physiciansand patients. A significant part of our business is acting as thebiopharma’ssales forcetophysicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.
Position Summary:
Responsibilities will vary by program and its lifecycle. Care Manager’s maybe responsible forcontacting insurance companies to obtain correct eligibility information, perform benefit investigations, copayassistanceand check prior authorization and/or appeal status. Care Managers may alsobe responsible fordirectly contacting patients and/or providers to evaluate eligibility forassistanceprograms and/or variedadherencesupport. This is aremoteposition.
Job Responsibilities:
- Perform outbound calls to obtainappropriate informationanddocumentaccurately.
- Responsible for answering in-bound calls andassistingcustomers withpharmacy relatedservices.
- Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service.
- Contact insurance companies for benefit investigation and coverage eligibility.
- Provide prior authorizations and appeals support.
- Assistpatients with the enrollment process for manufacturer and non-profitorganizationcopayassistanceprograms.
- Update job knowledge byparticipatingin educational opportunities and training activities. Work efficiently both individually and within a team toaccomplishrequired tasks.
- Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI’s.
- Report ADE’s according to program policy and guidelinesAdhereto all HIPAA guidelines Mayassistwith onboarding new employees.
Schedule:
- Must be available for an8 hourshift between 8am-8pm EST
RequiredQualifications:
- High School Diploma or equivalent
- Minimum oneyearexperience in medical billing, reimbursement, insurance verification, or similar related medical office experience.
- Previousdata entry experience (minimum three months) and ability to type 30wpm+.
- Able todemonstratehigh attention to detail in work.
- Mustbe computer savvy,to includenavigating multiple computer tabs,monitors,and applications.
- Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook,etc.) and soft phone systems (WebEx, Mitel,Shoretel, etc.).
- Exceptional communication skills, both written and verbal.
- Able to work in a virtual team environment by being available and responsive during working hours.
- Excellent follow through This is a remote position.
- Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines.
- Workspace must include internet plug-in accessibility. Wi-fi connectivity is notpermitted.
- Mustresidein country wherethe jobis posted.
Preferred Qualifications:
- Some College.
- Bilingual Spanish – English
- Previousexperience in Patient Support Services (Hub).
- PreviousCustomer Service experience in the healthcare field.