Account Care Educator - Specialty Pharmacy

This role works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product. You will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues.

• Single point of contact for questions and inquiries from the prescriber, patient, and field agent by territory.
• Identifies applicable programs and facilitates next steps.
• Holistically communicates the statuses of all patient support activities.
• Liaison with other program-specific Assist resources to secure outcomes for active patients.
• Accepts inbound calls for assigned territory or overflow of other territories and provides one call resolution support.
• Ensures protection is insured.
• Performs other related duties as assigned by management.

Qualifications

• College degree is preferred or high school diploma or equivalent combination of education and experience.
• Other skills required:
  • Previous work experience in Medical Reimbursement or Customer Service.
  • Submitting billing data to appropriate insurance providers.
  • Processing claims and resolving denial instances.
  • Achieving maximum reimbursement for services provided.
  • Completing Medicare and Commercial insurance claim submission.
  • Documenting and reporting payment information.
  • Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications, and keyboard skills.
  • Demonstrated strong written and verbal communication skills with providers, patients and insurance companies.
  • Interpersonal skills to facilitate work with a wide range of individuals and groups from culturally diverse publics.
  • Problem solving skills.

• Attendance/Punctuality - Is consistently at work and on time;
  Ensures work responsibilities are covered when absent;
  Arrives at meetings and appointments on time.
• Customer Service - Manages difficult or emotional customer situations;
  Responds promptly to customer needs;
  Solicits customer feedback to improve service;
  Responds to requests for service and assistance;
  Meets commitments.
• Dependability - Follows instructions, responds to management direction;
  Takes responsibility for own actions;
  Keeps commitments;
  Commits to long hours of work when necessary to reach goals;
  Completes tasks on time or notifies appropriate person with an alternate plan.
• Professionalism - Approaches others in a tactful manner;
  Reacts well under pressure;
  Treats others with respect and consideration regardless of their status or position;
  Accepts responsibility for own actions;
  Follows through on commitments.
• Quality - Demonstrates accuracy and thoroughness;
  Looks for ways to improve and promote quality;
  Applies feedback to improve performance;
  Monitors own work to ensure quality.
• Teamwork - Balances team and individual responsibilities;
  Exhibits objectivity and openness to others' views;
  Gives and welcomes feedback;
  Contributes to building a positive team spirit;
  Puts success of team above own interests;
  Able to build morale and group commitments to goals and objectives;
  Supports everyone's efforts to succeed.
• Diversity - Demonstrates knowledge of EEO policy;
  Shows respect and sensitivity for cultural differences;
  Educates others on the value of diversity;
  Promotes a harassment-free environment;
  Builds a diverse workforce.
• Ethics - Treats people with respect;
  Keeps commitments;
  Inspires the trust of others;
  Works with integrity and ethically;
  Upholds organizational values.

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance

• Preloaded PTO
  : 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary.
  Tenure vacation bonus
  : $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary.
• Impactful Work
  :
  Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications.
• Flexible Culture
  :
  Many associates earn the opportunity to work from home after 120 days. Enjoy a flexible…