Program Specialist II - Mason, OH, USA
Full-time
Department: Patient Services
Job Family: Customer Service & Engagement
Company Description:
EVERSANA is a certified Great Place to Work, committed to creating a healthier world through next-generation commercialization services in the life sciences industry. Our 7,000+ global employees support 650+ clients, ranging from biotech start-ups to established pharmaceutical companies. We value diversity and inclusivity while striving to improve patient lives.
Job Description:
THE POSITION:
The Program Specialist II provides dedicated support to patients and healthcare providers, addressing benefit coverage, payments, reimbursements, denials, and inquiries through the patient services support center.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Provide personalized support via phone and online portals.
Investigate and answer questions regarding insurance benefits, including coverage and out-of-pocket costs.
Assist with payments, reimbursements, denials, and appeals while making outbound calls for additional information.
Support prior authorization, benefit verification, and medical necessity processes.
Search for alternate reimbursement resources and assist with patient enrollment in qualified programs.
Respond to inquiries from customers, sales representatives, and business partners in a timely and professional manner.
Enter orders, change orders, track shipments, and document customer interactions.
Process patient assistance applications based on program business rules.
Adhere to company and client policies and procedures.
EXPECTATIONS OF THE JOB:
Assist with benefit verifications and prior authorizations.
Serve as the primary contact for healthcare providers to obtain patient and insurance information.
Maintain accurate documentation and records as required.
Foster collaboration and effective communication within the team.
Deliver results professionally, ethically, and responsibly.
MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES:
High School Diploma with 4 years’ experience or Associate’s Degree with 2 years’ experience in a healthcare setting.
Strong oral, written, and interpersonal communication skills.
Ability to multi-task in a fast-paced, metric-driven environment.
Positive attitude, accuracy, and attention to detail.
Proficiency in Microsoft Word, Excel, and PowerPoint.
PREFERRED QUALIFICATIONS:
Customer service and/or call center experience.
Experience in patient assistance, reimbursement, or pharmacy benefit management.
Medical billing and coding experience.
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.
Grow Talent: Invest in personal and team development.
Win Together: Collaborate passionately to achieve results.
Communication Matters: Encourage transparent, timely dialogue.
Embrace Diversity: Create an inclusive environment.
Always Innovate: Be bold and creative in every action.
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