Description
POSITION SUMMARY:
The Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions.
POSITION RESPONSIBILITIES:
• Review and process patients' enrollment forms to the Patient Assistance Program (PAP)
• Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.
• Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process
• Schedule treatments to be sent to the patient or patient's healthcare provider
• Support inbound and outbound phone lines for the PAP program
• Communicate daily with patient/authorized representative on eligibility based on PAP criteria and healthcare providers to manage expectations.
• Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer's PAP program.
• Prioritize workload to ensure patients' enrollments are processed within specified timeframe
• Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician's office staff.
• Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates and caregivers.
• Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.
• Execute day-to-day operations specific to the assigned program(s).
• Maintain patient confidentiality at all times.
REQUIRED EDUCATION AND EXPERIENCE:
• High school diploma or equivalent
• Two (2) years of work experience in a customer service or customer focused role
• One (1) year of work experience in a call center environment.
• Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers
• Must have proven ability to provide consistently high-quality of service
PREFERRED EDUCATION AND EXPERIENCE:
• Associate Degree or technical school training in a related field
• Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field
• Experience with HIPAA and patient services
• Bi-lingual, English and Spanish
KNOWLEDGE, SKILLS & ABILITIES:
• Demonstrated empathy and compassion
• Excellent verbal and written communication skills
• Excellent organization skills and detail oriented
• Balance multiple priorities to meet expected response deadlines
• Adaptable, flexible and readily adjust to changing situations
• Ability to work independently and as a member of a team
• Ability to comprehend and apply basic math principles
• Ability to apply logical thinking when evaluating practical problems
• Ability to present information and respond to questions from stakeholders
• Ability to interact with a diverse group
• Ability to listen and demonstrate a high degree of empathy
• Demonstrated computer skills includes Microsoft Word, Excel, and Outlook
• Display tact and diplomacy in response to unfavorable or negative situations
• Demonstrated sensitivity and understanding when speaking with patients
• Demonstrated passion for speaking with people in an outgoing way
PHYSICAL REQUIREMENTS:
• Location of job activities 100% inside
• Extensive manual dexterity (keyboarding, mouse, phone)
• Constant use of phone for communication
• Noise and/or vibrations exposure
• Frequently reach (overhead), handle, and feel with hands and arms
• Sit for prolonged periods of time
• Occasionally stoop, kneel, and crouch
• Occasionally lift, carry, and move up to 25 pounds
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
