Program Specialist

Role & responsibilities

The Program Specialist is responsible for serving as the customers primary point of contact providing operational and reimbursement support to complex programs within the Company , including but not limited to, marketing support, reimbursement hotlines, patient assistance programs, Hubs, foundations, safety surveillance programs, case management, and compliance programs. The focus of the Program Specialist is to own issues and remove obstacles that prevent patients or providers from accessing the therapies requested. The Program Specialist will be a self-starter who is comfortable taking initiative, identifying barriers, being on the phones and working with the appropriate parties to eliminate these obstructions for the customer. The Program Specialist is proficient and knowledgeable about all the services provided on an assigned program and may support multiple client products or programs.

Key Responsibility:

• Quickly and efficiently respond to incoming calls and faxes, identify how best to assist. • Conduct outbound calls of insurance verifications to understand if patients prescribed therapy is eligible for coverage. Document results in appropriate tracking system. • Document calls in appropriate tracking systems, and handle/escalate calls per established procedures. • Process patient applications and follow the program's specifications to determine their eligibility. Document results in appropriate tracking system and manage follow-ups as appropriate. Place follow-up calls and respond to enquiries from patients and/or healthcare providers as necessary. • Maintain a professional, calm and friendly demeanor. Express thoughts and instructions clearly in both verbal and written communication; i.e. uses grammatically correct and concise language. • Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate. • Be familiar with the market place and the insurance options available for patients. Educate patients on the available options as appropriate. • Strict adherence to follow the process SOPs

Preferred candidate profile

• Experience:

The Program Specialist ideally should have two or more years of prior customer service, volunteering, or other customer-facing experience. Prior experience in the US healthcare industry is a must , and the Program Specialist must be a proven problem solver with the ability, drive, and initiative to learn the required healthcare, reimbursement, and customer service skills necessary to support the assigned program(s). Experience in handling sensitive data in US healthcare with high degree of proficiency. Must be familiar with HIPAA guidelines. Candidates should be flexible in working from home or in an office setting per business needs.

• Education:

The Program Specialist ideally will hold a bachelors degree or a Masters Degree with all Documents from a regular College/University.