Healthcare Call Center Specialist
Location: Mason, OH, USA | Employment Type: Full-Time
Department: Patient Services | Job Family: Customer Service & Engagement
Company Overview
EVERSANA® is a global leader in life sciences commercialization, delivering innovative solutions that improve patient access to therapies worldwide. With over 7,000 employees serving more than 650 clients, from emerging biotech startups to established pharmaceutical companies, we drive patient-focused outcomes while supporting commercial success.
Recognized as a Great Place to Work®, EVERSANA values diversity, inclusion, and collaboration, empowering employees to innovate, grow, and make an impact in the healthcare ecosystem.
Role Overview
The Healthcare Call Center Specialist provides critical patient and healthcare professional (HCP) support by assisting with reimbursement, benefit coverage, prior authorizations, claim denials, appeals, triage to third-party support centers, and general inquiries. This role ensures patients and providers receive accurate, timely, and compliant information while maintaining the highest standard of customer service.
Key Responsibilities
Deliver dedicated, personalized support via phone, email, and CRM systems.
Conduct benefit verification, insurance coverage assessment, and out-of-pocket cost inquiries.
Assist with prior authorization, medical necessity documentation, and benefit verification processes in alignment with industry best practices.
Triage calls to third-party support centers as appropriate.
Conduct enrollment intake for incoming inquiries.
Participate in quality improvement initiatives, training, and ongoing professional development.
Maintain a positive, patient-focused attitude while adhering to company and client policies.
Qualifications
Minimum Knowledge, Skills, and Abilities:
Strong pharmacy reimbursement experience, with solid understanding of prior authorization processes.
Experience performing benefit verifications with payers, ideally supporting retail prescription drug products.
Knowledge of healthcare administration, billing, and reimbursement regulations.
Excellent oral, written, and interpersonal communication skills.
Ability to multitask, work independently, and function collaboratively in a team environment.
Proficient in Microsoft Office (Word, Excel, PowerPoint).
Detail-oriented with a positive, patient-centered approach.
Ability to work rotating 8-hour shifts, Monday through Friday.
Preferred Qualifications:
Prior experience in customer service, call centers, or patient services.
Familiarity with retail pharmacy operations.
Reimbursement or healthcare support experience.
Physical & Work Environment
Office-based role; frequently required to sit, stand, walk, talk, hear, and occasionally lift up to 25 pounds.
Work environment may have moderate noise with frequent interruptions and multiple demands.
Ability to work in a fast-paced, metric-driven environment while remaining patient-minded.
Why Join EVERSANA
Deliver meaningful impact by supporting patients, HCPs, and payers in the healthcare ecosystem.
Participate in a collaborative, inclusive, and innovative culture.
Access ongoing training and professional development opportunities.
Competitive compensation and benefits package.
EVERSANA Core Values
Patient Minded: Always act in the patient’s best interest.
Client Delight: Take ownership of every client interaction.
Take Action: Be empowered and accountable.
Grow Talent: Invest in personal and team development.
Win Together: Collaborate to achieve results.
Communication Matters: Promote transparent and timely dialogue.
Embrace Diversity: Foster awareness, respect, and inclusion.
Always Innovate: Apply creativity and bold thinking to all tasks.
Application Instructions:
EVERSANA is an Equal Opportunity Employer committed to diversity, equity, and inclusion. Reasonable accommodations are provided in accordance with ADA regulations. Applicants must submit resumes in English.
Note: EVERSANA will never request payment or sensitive personal information during recruitment.
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