Medical Call Center Reps
Perform duties to support patients with access to patient assistance programs and provide administrative support to department Patient Advocacy Team, working within the limits of prescribed routines.
? Receive notification of patients in need of financial assistance to cover the cost of their prescriptions. Advise patients and/or caregivers of insurance benefits and financial obligations for the prescribed therapies.
? Educate patient on available insurance options including Medicate part D, Medicaid, Healthcare Exchange, and Social Security Low Income Subsidy program. Follow up with qualifying patients to confirm status of applications and facilitate authorization process for prescription once coverage is available.
? Communicate with patients regarding available assistance programs and community resources that provide the required assistance and the processes necessary to obtain the patient assistance.
? Obtain required information and permission from patients to submit electronic applications for financial assistance on their behalf. Provide patients with forms required by assistance providers, follow up to offer assistance to complete documents properly, and ensure that applications are filed in keeping with defined time limits to avoid interruption in therapy.
? Follow up with assistance providers to determine the status of applications, expedite consideration of requests, advocate on behalf of patients, and track the status of applications and related activity.
? Document patient assistance case activity, communications, and correspondence in computer system to ensure completeness and accuracy of patient contact records. Enter patient assistance approval information to patient account to ensure accurate claim processing and billing. Transfer/triage the prescription to the appropriate site based on insurance contracts and drug availability. Complete applicable assessments to track patient assistance program outcomes.
? Respond to incoming calls from current patients, prescribers' offices, and patient assistance programs as primary representative to ensure continuity and maintenance of therapy while building trusted and enduring customer relationships that yield loyalty. Provide ongoing communication of specific case-related information as appropriate.
? Support the team with data entry, recordkeeping and other administrative assignments required to maintain departmental workflow.
? Perform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirements.
? Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
? Perform other related duties as assigned.
? High school Diploma or GED equivalent required. College education preferred.
? Additional specialized training in general office routines and computer and software operation.
? Minimum 1 year previous work experience in a healthcare or social service setting strongly preferred.
? Previous and proven experience in dealing with patients/clients via telephone with a high touch, high quality customer service experience.
? Understanding of clinical terms, benefits investigation, and disease states preferred.
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