Patient Care Coordinator

· Receive inbound and outbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution
· Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience
· Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services
· Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes
· Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed
· Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance
· Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products
· Process enrollments via fax, phone, and electronically as needed
· Scrutinize forms and supporting documentation thoroughly for any missing information or new information to be added to the database 

Job Title : Patient care/ Patient access 
Location : 100% Remote
Project Duration :  06 months
 
Interviews in July
Bilingual in Spanish

Schedule: Must be able to work any 8hr shift between 7AM-7PM (CST) as assigned.
 
Training: Onboarding Training schedule will be 8AM-5PM (CST) Training typically lasts for first 4-6 weeks of the assignment. Virtual attendance is mandatory.

Job Description:
 
Top Skills:
Together, we can get life-changing therapies to patients who need them—faster.
Responsibilities:
· Receive inbound and outbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution
· Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience
· Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services
· Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes
· Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed
· Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance
· Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products
· Process enrollments via fax, phone, and electronically as needed
· Scrutinize forms and supporting documentation thoroughly for any missing information or new information to be added to the database 
 
Qualifications:
· 2-4 years of industry experience with patient-facing or high touch customer interaction experience preferred
· Previous Hub or Patient Support Service experience preferred
· High School diploma or equivalent preferred
· Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred
· Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust.   
· Robust computer literacy skills including data entry and MS Office-based software programs 
· Strong understanding of pharmaceutical therapies, disease states, and medication adherence challenges preferred
· Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers

What is expected of you and others at this level:
· Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
· In-depth knowledge in technical or specialty area
· Applies advanced skills to resolve complex problems independently
· May modify process to resolve situations
· Works independently within established procedures; may receive general guidance on new assignments
· May provide general guidance or technical assistance to less experienced team members