Job Title:
Healthcare Call Center Specialist
Company:
EVERSANA
Location: Mason, Ohio, USA
Department: Patient Services – Customer Service & Engagement
Job Type: Full-Time
About the Company:
EVERSANA is a leading global provider of commercialization services to the life sciences industry, with over 7,000 employees and 650+ clients worldwide. The company is focused on patient outcomes, innovation, and creating an inclusive culture grounded in shared values and diversity.
Job Summary:
The Healthcare Call Center Specialist supports patients, healthcare providers (HCPs), and payers by managing inquiries related to insurance coverage, benefit verification, claim denials, prior authorizations, and appeals. The specialist serves as a primary point of contact to ensure patients receive timely, accurate support regarding access to therapy.
Key Responsibilities:
Patient & Provider Support
Respond to inquiries via phone, CRM, and email
Conduct benefit investigations and explain coverage and cost details
Provide support with prior authorizations and appeal processes
Triage & Workflow Management
Identify and forward cases to third-party support centers when appropriate
Intake and process patient enrollment inquiries
Ensure accurate data entry and documentation in support systems
Team & Process Improvement
Participate in training and quality improvement initiatives
Maintain a positive, patient-focused approach
Collaborate effectively with internal and external stakeholders
Job Expectations:
Work Monday–Friday on rotating 8-hour shifts
Maintain excellent attendance and adherence to procedures
Handle patient issues ethically and responsibly
Foster team collaboration and transparent communication
Apply critical thinking for problem-solving and escalation
Minimum Qualifications:
Strong pharmacy reimbursement knowledge, including prior authorization procedures
Experience in benefit verification, particularly with retail prescription drug products
Understanding of healthcare administration, billing, and reimbursement regulations
Proficiency in Microsoft Word, Excel, and PowerPoint
Excellent verbal and written communication skills
Detail-oriented with strong multitasking capabilities
Preferred Qualifications:
Experience in customer service or contact center roles
Familiarity with reimbursement or patient support services
Knowledge of retail pharmacy operations
Work Environment:
Office-based role with frequent sitting, phone use, and computer work
Occasional lifting up to 25 pounds
Moderate noise level and frequent interruptions
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