Two Chicks With A Side Hustle

  • Handle all escalations based upon region and ensure proper communication of the resolution within required timeframe agreed upon by the client
  • Serve as a liaison between client sales force and applicable party
  • Ability to effectively 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
  • Log and maintain a reconciliation report for all Field requests to send to client at their designated preferred date range
  • Support team with call overflow and intake when needed
  • Must self-audit activities to ensure accuracy and efficiency for the program
  • As needed conduct research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues swiftly
  • Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.

Qualifications

  • Previous customer service experience, preferred
  • High School diploma or equivalent, preferred
  • Demonstrated high level customer service
  • Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred
  • Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
  • Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred

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