Job Summary:Key Responsibilities:|
- Work with a team of specialists dedicated to one of our manufacturer partners, to provide reimbursement support services. Will have direct interaction with the manufacturer client to provide case statuses and updates as well as with the patient and physician offices.
o Knowledge and skills to properly verify patient’s prescription benefits and obtain prior authorizations for patient’s therapy utilizing both CPR+ and Business Blocks
- Responsible for providing employees with timely, candid and constructive feedback; developing employees to their full potential and providing challenging opportunities that enhance employee career growth; developing the appropriate talent pool to ensure adequate bench strength and succession planning; recognizing and rewarding employees for accomplishments.
o Lead team of reimbursement and operation specialists to ensure they perform daily responsibilities and assigned tasks, while maintaining performance standards.
o Ensures quality of care is provided and departmental policies and procedures are followed.
o Set goals for team and provide motivation and follow up to reach those goals.
o Ability to train both new and existing team members on the Cisco phone system and the inbound queue, creation of both Fax and Phone Service Requests, and all aspects of Benefits Investigation, Prior Authorizations and pursuit of Appeals
o Responsible for assigning and monitoring referral work load to the team.
o Perform quality audits for the team
o Assist managers with daily reports, Co-pay assistance and other duties as needed.
o Manage incoming and outgoing correspondence with our partners via the Portal or email.
o Take escalation calls and resolves patient issues.
o Effectively work with data analysts to assure all reporting issues are worked out and entered accurately and timely.
o Participates in special projects and attends and/or conducts meetings in the department.
o Solid knowledge of our program guidelines, contractual obligations, department goals and operations. Cross-trained to perform all roles within the team.
o Other duties as assigned.
Minimum (Required) Qualifications:
- Management experience or demonstrated leadership preferred
- Minimum of three (3) years work experience in applicant patient areas
- Associates degree in related field or equivalent experience is required.
Omnicare, Inc - 15 months ago