Job Title:
Program Specialist II
Company:
EVERSANA
Location: Mason, OH, USA
Department: Patient Services – Customer Service & Engagement
Job Type: Full-Time
About the Company:
EVERSANA is a global leader in commercialization services for the life sciences industry. With a workforce of over 7,000 and partnerships with more than 650 clients, the company is dedicated to improving patient outcomes by delivering innovative therapies through integrated services, data, and technology solutions.
Job Summary:
The Program Specialist II provides dedicated support for activities related to benefit coverage, payments, reimbursements, denials, and general inquiry phone calls. This role helps both patients and healthcare providers with issues related to payment assistance, reimbursement, and insurance verifications.
Key Responsibilities:
Benefit Verification & Assistance
Verify patient insurance benefits and coverage details
Assist with prior authorization, medical necessity processes, and benefit verification
Resolve issues related to reimbursements, payment denials, and appeals
Patient Support & Communication
Provide personalized support via phone and online portal
Communicate with patients and healthcare providers to gather necessary information
Make outbound calls to customers for additional information as needed
Program Assistance & Administration
Administer patient assistance applications and follow-up on program enrollments
Assist with identifying alternative reimbursement resources (e.g., state/federal programs)
Process customer transactions, maintain logs, and track shipments
Minimum Qualifications:
High School Diploma with 4 years of healthcare experience, or Associate’s Degree with 2 years of experience in a healthcare setting
Strong verbal, written, and interpersonal communication skills
Ability to multitask in a fast-paced, metric-driven environment
Strong attention to detail and ability to work independently and as part of a team
Proficient in Microsoft Word, Excel, and PowerPoint
Preferred Qualifications:
Experience in customer service or call center environments
Familiarity with patient assistance, reimbursement, or pharmacy benefit management
Knowledge of medical billing and coding
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