• Notify patients, physicians, practitioners, and or clinics of any financial responsibility of services provided as applicable
• Assess patient’s financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
• Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted
• Track any payer/plan issues and report any changes, updates, or trends to management
• Search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation
• Handle all escalations based upon region and ensure proper communication of the resolution within required time frame agreed upon by the client
• Serve as a liaison between client sales force and applicable party
• Mediate situations in which parties are in disagreement and facilitate a positive outcome
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
• Responsible for reporting any payer issues by region with the appropriate team
• As needed conduct research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues swiftly
What is expected of you and others at this level
• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
• In-depth knowledge in technical or specialty area
• Applies advanced skills to resolve complex problems independently
• May modify process to resolve situations
• Works independently within established procedures; may receive general guidance on new assignments
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