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    Healthcare Call Center Specialist

    Eversana
    2+ years
    Not Disclosed
    Remote, USA
    10 Nov. 27, 2024
    Job Description
    Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

    EVERSANA Healthcare Call Center Specialist - Program Specialist II

    Company Description: At EVERSANA, we are proud to be certified as a Great Place to Work globally. We are driven by a vision to create a healthier world, with a global team of over 7,000 employees committed to delivering next-generation commercialization services to the life sciences industry. We partner with more than 650 clients, from innovative biotech startups to established pharmaceutical companies, helping bring transformative therapies to market and supporting the patients who rely on them.

    Diversity is at the core of who we are, and we are intentional about fostering an inclusive culture where people from all backgrounds can thrive. Our team is dedicated to improving patient lives worldwide, and we need people with diverse experiences to help shape the future of healthcare and life sciences. Together, we make an impact every day. Join us and be part of a company that values talent, creativity, and collaboration.

    Job Description: The Healthcare Call Center Specialist (Program Specialist II) will provide essential support to patients and healthcare providers through our patient services support center. This role involves assisting with benefit coverage, payments, reimbursements, denials, and general inquiries, ensuring seamless and personalized service to meet patient and doctor needs.

    Essential Duties and Responsibilities:

    • Provide personalized, phone-based support to patients and doctors, addressing benefit coverage, payments, reimbursement issues, and denials.
    • Collaborate with patients and healthcare providers to resolve issues related to payment denials and assist with appeals processes.
    • Assist with prior authorization, medical necessity processes, benefit verification, and authorization assistance.
    • Conduct thorough searches for alternative reimbursement resources, including state and federal programs, and provide enrollment assistance for qualified patients.
    • Respond to inquiries from customers, sales representatives, and business partners, ensuring timely follow-ups and professional communication.
    • Process patient assistance applications in compliance with program guidelines.
    • Maintain accurate records of transactions, including order entries, changes, and customer notes.
    • Perform other tasks and projects as assigned to support the overall team.

    Expectations of the Job:

    • Act as the primary point of contact for healthcare providers, ensuring complete patient enrollment and insurance information.
    • Adhere to company policies and procedures, ensuring efficient, ethical, and professional handling of all customer interactions.
    • Foster a team-oriented, collaborative environment, with open communication and problem-solving skills.
    • Focus on results and deliver on promises, ensuring the highest level of patient care and satisfaction.
    • Maintain excellent attendance and a positive, helpful attitude.

    Qualifications:

    Minimum Knowledge, Skills, and Abilities:

    • High School Diploma and 4 years of experience, or an Associate’s Degree with 2 years of experience in a healthcare setting.
    • Strong verbal, written, and interpersonal communication skills.
    • Ability to multitask, remain patient-minded, and handle customer inquiries in a fast-paced, metric-driven environment.
    • Detail-oriented with strong organizational skills.
    • Proficient in Microsoft Word, Excel, and PowerPoint.

    Preferred Qualifications:

    • Experience in customer service, call centers, or patient assistance programs.
    • Familiarity with reimbursement, pharmacy benefit management, and medical billing and coding.

    Physical/Mental Demands and Working Environment:

    • Frequent standing, sitting, walking, and occasional lifting (up to 25 pounds).
    • The noise level is moderate, with interruptions and multiple demands throughout the shift.
    • Ability to work in a fast-paced office environment while maintaining focus on customer service excellence.

    Additional Information:

    Our Cultural Beliefs:

    • Patient Minded: I act with the patient’s best interest in mind.
    • Client Delight: I own every client experience and its impact on results.
    • Take Action: I am empowered and empower others to act now.
    • Grow Talent: I own my development and invest in the development of others.
    • Win Together: I passionately connect with anyone, anywhere, anytime to achieve results.
    • Communication Matters: I speak up to create transparent, thoughtful, and timely dialogue.
    • Embrace Diversity: I create an environment of awareness and respect.
    • Always Innovate: I am bold and creative in everything I do.

    Diversity, Equity & Inclusion are core values at EVERSANA. We are an Equal Opportunity Employer, fostering an environment where employees from diverse backgrounds—whether in race, gender identity, age, disability, veteran status, sexual orientation, religion, or other aspects—are valued for their unique perspectives. Diversity and inclusion are integral to our success, and we encourage all individuals to apply and contribute to our mission of improving patient lives globally.

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