Customer Service Representative - Patient Services

2+ years

Not Disclosed

Remote, USA

10 Nov. 27, 2024

Job Description

Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

EVERSANA Customer Service Representative (Program Specialist II)

Company Description:
At EVERSANA, we take pride in being recognized as a Great Place to Work worldwide. Our mission is to create a healthier world, and we’re fueled by a global team of over 7,000 employees dedicated to delivering next-generation commercialization services for the life sciences industry. Serving more than 650 clients—from biotech start-ups to major pharmaceutical companies—we bring innovative therapies to market and support the patients who rely on them. Together, we make a difference every day.

We embrace diversity and believe that people from all backgrounds and experiences are essential in shaping the future of healthcare. Our inclusive culture encourages each individual to thrive and contribute to our mission of improving patient lives. We are EVERSANA.

Job Description:
The Customer Service Representative (or Program Specialist II) will provide dedicated support to patients and healthcare providers, assisting with benefit coverage, payments, reimbursements, denials, and general inquiries through our patient services support center. This role will require excellent communication skills, attention to detail, and the ability to navigate complex healthcare systems to deliver a positive customer experience.

Essential Duties and Responsibilities:

Provide personalized, dedicated support to patients and healthcare providers over the phone and via online portals.
Investigate and answer questions about insurance benefits, coverage, and out-of-pocket costs.
Collaborate with patients and doctors to address issues related to payments, reimbursements, payment denials, and appeals.
Assist with prior authorization and medical necessity processes, benefit verification, and prior authorization assistance.
Conduct searches for alternate reimbursement resources, such as state and federal assistance programs, and provide enrollment support for qualified patients.
Respond to inquiries from customers, sales representatives, and business partners, following up in a timely, courteous, and professional manner.
Maintain positive relationships with clients and customers while delivering exceptional service.
Enter orders, change orders, track shipments, and maintain customer records as needed.
Process patient assistance applications in line with program guidelines.
Support additional tasks and projects as assigned.

Expectations of the Job:

Act as the primary point of contact for healthcare providers to ensure complete patient enrollment and insurance information.
Learn, understand, and follow all company and client policies and procedures.
Work collaboratively and communicate clearly with team members, vendors, and clients.
Maintain accountability for work practices and deliver results as promised.
Use critical thinking and problem-solving skills to address customer issues efficiently.
Maintain excellent attendance and a positive attitude in a fast-paced, metric-driven environment.

Qualifications:

Minimum Knowledge, Skills, and Abilities:

High School Diploma with 4 years’ experience or an Associate’s Degree with 2 years’ experience in a healthcare setting.
Excellent oral, written, and interpersonal communication skills.
Ability to multitask, stay organized, and maintain attention to detail.
Positive attitude and strong customer service skills.
Ability to work both independently and as part of a team.
Ability to thrive in a fast-paced, metrics-driven environment while keeping the patient’s best interest in mind.
Proficiency in Microsoft Word, Excel, and PowerPoint.

Preferred Qualifications:

Experience in customer service or call centers.
Background in patient assistance, reimbursement, or pharmacy benefit management.
Experience with medical billing and coding.

Physical/Mental Demands and Working Environment:

The position requires frequent sitting for long periods (up to 90% of the shift), walking, talking, and hearing.
Occasionally, lifting and/or moving up to 25 pounds may be required.
The work environment is moderately quiet but may involve frequent interruptions and multiple demands.

Cultural Beliefs at EVERSANA:

Patient Minded: We act with the patient’s best interests at heart.
Client Delight: We take ownership of every client experience and its results.
Take Action: We empower ourselves and others to act now.
Grow Talent: We invest in our own development and that of others.
Win Together: We collaborate to achieve results.
Communication Matters: We create transparent, thoughtful, and timely dialogue.
Embrace Diversity: We foster an environment of awareness and respect.
Always Innovate: We are bold and creative in everything we do.

At EVERSANA, Diversity, Equity, and Inclusion are integral to our success. As an Equal Opportunity Employer, we welcome individuals from diverse backgrounds, including race, gender, age, disability status, veteran status, sexual orientation, religion, and other identities. We value each employee's perspective, as inclusion is everyone’s responsibility.

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Customer Service Representative - Patient Services

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