Customer Service Specialist

Primary Responsibilities:

• Explains all Company programs and services to patients and provider’s office staff, including what to expect with Company specialty services, contents of shipments, and patient rights.

• Acts as a liaison between Company, patients, insurance, Pharma, and provider’s offices via phone, fax, and email communications.

• Contacts patients to provide onboarding welcome calls, schedule new medication deliveries, confirm demographic and address information, and inform them of any copayment responsibilities.

• Enters data requirements into tracking software. Transfers call to clinical staff for clinical education/assessment activities.

• Places monthly refill reminder calls to patients; refers patients to the clinical pharmacist or nurse as needed.

• Communicates with patients as needed based on prescription refills and refers any medication or illness-related questions or concerns to a board-licensed healthcare professional, including but not limited to pharmacists, nurses, or supervised pharmacy interns.

• Notifies appropriate staff of relevant information gathered during calls to providers or patients that may affect a patient’s disease state, medication regimen or method of funding.

• Records and processes orders and/or inquiries received by mail, telephone and/or through direct patient contact.

• Provides timely response to patient inquiries by telephone and/or email in an inbound or outbound manner, consistent with service and quality standards.

• Maintains documentation of calls to and from patients, caregivers, insurance, providers, and Pharma.

• Creates patient activities as a reminder for the following tasks, including, but not limited to, follow-up calls, clinical assessments, referrals to Case Management, initiation of discharge, patient letter mailings, or other reminders as it relates to the patient’s care.

• Must maintain the established workflow within the patient care department and adhere to the company/department’s Policy and Procedure manual.

• Adheres to all company policies as indicated in the handbook and directives issued by management. Has reviewed Policy and Procedure manual.

Professional Competencies:

• Proficient with MS Excel, Word, and Outlook

• Demonstrated ability to meet tight deadlines

• Must be detail oriented with a high degree of accuracy

• Ability to work with all levels of internal management and staff, as well as outside clients and vendors

• Working knowledge of Medicare, Medicaid, and Commercial Insurance related to pharmacy billing, prior authorizations, insurance verification, and medical terminology preferred

• Must be knowledgeable in Medicare, Medicaid, Commercial insurance, and renal programs and how they apply to transplant and specialty patients

• Knowledgeable in the process of insurance verification and online prescription adjudication

Education:

High School Diploma or equivalent

Required Qualifications:

• Working knowledge of the healthcare industry

• HIPAA trained and /or the ability to work with and protect highly confidential patient and employee information

Physical Requirements:

• Must be able to remain in a stationary position up to 90% of the time

• The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote events

• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer

• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations

• The ability to observe details at close range (within a few feet of the observer)

Working Conditions:

Normal office environment.

Equipment Used to Perform the Job:

Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work. Software specific to the position, including but not limited to Microsoft Outlook and Skype. Must lift and traverse the area to move paper and supplies to use the equipment.

Contacts: