Healthcare Call Center Specialist - Mason, OH, USA
Full-time
Department: Patient Services
Job Family: Customer Service & Engagement
Company Description:
At EVERSANA, we are proud to be certified as a Great Place to Work across the globe. Our global team of over 7,000 employees is committed to creating and delivering next-generation commercialization services to the life sciences industry. We serve over 650 clients, ranging from biotech start-ups to established pharmaceutical companies, helping bring innovative therapies to market and supporting the patients who depend on them.
Job Description:
Position:
The Healthcare Call Center Specialist (Program Specialist II) will provide dedicated support to patients and doctors regarding benefit coverage, payments, reimbursements, denials, and general inquiries through our patient services support center.
Essential Duties and Responsibilities:
Provide personalized support over the phone and via the online portal.
Investigate and answer questions regarding insurance benefits, coverage, and out-of-pocket costs.
Collaborate with patients and doctors to resolve payment, reimbursement, and denial issues.
Make outbound calls to customers for additional information.
Assist with prior authorization, medical necessity processes, and benefit verification.
Conduct comprehensive searches for alternate reimbursement resources and assist with enrollment.
Respond to customer inquiries and follow up on requests in a professional manner.
Process orders, track shipments, and update customer records.
Process patient assistance applications according to program rules.
Maintain logs and records as required.
Perform other tasks and projects as assigned.
Expectations:
Assist with benefit verifications and prior authorizations.
Serve as the primary contact for healthcare providers to obtain complete patient and insurance information.
Learn and follow all company and client policies and procedures.
Demonstrate accountability and ethical behavior in all work practices.
Foster a collaborative, team-oriented environment.
Apply critical and creative thinking to solve work and customer issues.
Exhibit excellent attendance and reliability.
Qualifications:
Minimum Requirements:
High School Diploma with 4 years’ experience or Associate’s Degree with 2 years’ experience in a healthcare setting.
Excellent oral, written, and interpersonal communication skills.
Ability to multi-task and remain detail-oriented.
Positive attitude and ability to work independently as a team player.
Ability to thrive in a fast-paced, metric-driven environment.
Strong computer skills with proficiency in Microsoft Word, Excel, and PowerPoint.
Preferred Qualifications:
Customer service and/or call center experience.
Experience with patient assistance, reimbursement, and/or pharmacy benefit management.
Medical billing and coding experience.
Physical/Mental Demands and Working Environment:
Office environment requiring the ability to sit, stand, walk, talk, and hear for long periods.
Occasionally required to lift or move up to 25 pounds.
Moderate noise level with frequent interruptions and multiple demands.
Cultural Beliefs:
Patient Minded: Act with the patient’s best interest in mind.
Client Delight: Own every client experience and its impact on results.
Take Action: Empower yourself and others to act promptly.
Grow Talent: Invest in personal and team development.
Win Together: Passionately collaborate to achieve results.
Communication Matters: Promote transparent, thoughtful, and timely dialogue.
Embrace Diversity: Foster an environment of awareness and respect.
Always Innovate: Be bold and creative in every task.
EVERSANA is an Equal Opportunity Employer, embracing diversity and inclusion across all aspects of employment.
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