Job Description

Position Summary :

The Care Coordinator (CC) is responsible for customer service and case coordination. This position will help plan members access financial assistance programs. They will follow up with members, pharmacies, health care providers and/or financial assistance programs to confirm shipment/receipt of drug. From time to time, the CC will be in contact with PBMs and Payers (Funds, Plan Sponsors, Insurers) to gather information and assist plan members.

Responsibilities:

• Ensure that plan members meet plan eligibility requirements
• Act as primary point of contact for plan members
• Serve as plan member advocate and enhance the collaborative relationship between the plan member, health care provider, and patient assistance program representatives
• Document/record all interactions with members, health care providers, pharmacies, and financial assistance entities in the Customer Relationship Manager software (“CRM”) in a timely manner
• Provide exceptional customer service to internal and external customers; resolve any customer requests in a timely and accurate manner; escalates complaints accordingly
• Review pending activities/events and specific customer requests to ensure excellent customer service and customer experience
• Demonstrate proficiency and full understanding of the Company plan member database including data elements, definition of case statuses and outcomes, case documentation requirements and the importance of meeting company metrics
• Research and identify available financial assistance programs for specialty drugs that are prescribed for active members
• Coordinate access to patient assistance programs; provide assistance to plan members and physician staff to complete all necessary financial assistance program forms and applications in a timely manner

Preferred Requirements:

• Minimum 1+ years customer service experience, healthcare reimbursement and pharmaceutical experience
• Excellent written and oral communication skills
• Ability to multi-task and handle consistent workflow
• Pharmacy Technicians encouraged to apply
• Insurance verification experience preferred

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