From Intake to Outcomes, CareMetx is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.
Customer Support/Data Entry
Under the general supervision of the operational program leadership, The Customer Support Coordinator (CSC) / Intake Coordinator (IC) maybe a hybrid role between Customer Support and Data Entry functionalities based on the needs of the business. In this role the individual may be responsible for handling all inbound and/or outbound customer service inquiries via telephone from a patient, prescriber, insurance company, pharmacy, or an internal partner as well as review and assess incoming referrals to ensure requirements are met before a patient record is created in the database system. In this role the individual works to understand and solve problems in a timely manner. They document all interactions into the database and escalate issues as necessary.
PRIMARY DUTIES AND RESPONSIBILITIES:
Handle incoming customer service inquiries from patients, prescribers, insurance companies, external partners, or internal partners. Research and resolve problems in a timely manner. Assist the callers by helping them understand the need for additional information to complete the benefits investigation process, or transfer of the case to the pharmacy partner.
Create and/or edit a patient’s record in the database system by entering demographics, insurance information, and prescription from incoming referrals (referrals are received via incoming phone calls, facsimile, or a prescriber web portal).
May initiate outbound telephone calls to patients for various reasons such as to collect additional information to complete a benefit investigation, or to explain the outcome of the benefit investigation conducted by the Reimbursement Specialist among other reasons.
May make outreach to a prescriber via phone, facsimile, or mail to request additional information needed for the completion of a benefit investigation, provide the benefit outcome, or inform them in the event that the patient is not being responsive to telephone calls or mailed letters among other reasons.
Attach incoming facsimile images to a new or existing patient record.
May identify and escalate concerns received from patients, prescribers, partners, or insurance companies so that corrective action can be pursued accordingly.
Generate letters and brochures for patients, prescribers, or partners.
May document the outcome of all interactions associated with the patient record into the database system.
Adhere to the quality, production, and turnaround standards associated with the assigned program.
Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
Other duties as assigned.
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
High school diploma or equivalent
One or more years of experience in a highly skilled and fast paced call center environment. Call center experience in Specialty Pharmacy, Pharmacy Benefit Management (PBM), Commercial Insurance, or Patient Assistance Programs preferred, but not required.
Knowledge of medical terminology preferred, but not required.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
Detail oriented, good analytical skills, verbal and written communication skills, with demonstrated ability to communicate with others at all levels
Ability to multi-task, independently prioritize and able to meet deadlines in a high call
Excellent interpersonal and customer service skills with a focus on customer satisfaction.
Ability and initiative to work independently or as a team member.
Ability to problem solve.
Committed to high standards and accountability.
Ability to type at least 35 words per minute
Ability to adapt to a dynamic work environment
Ability to learn quickly
General computer knowledge including proficiency in Microsoft Office applications required
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
· While performing the duties of this job, the employee is regularly required to sit.
· The employee must occasionally lift and/or move up to 10 pounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
Must be flexible on schedule and hours
Overtime may be required from time to time
Must be willing to work weekends if required to meet company demands
CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.
At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.