Patient Services Representative

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver clearly defined services to patients, healthcare providers, and caregivers.

• Collaborate closely with patients and healthcare professionals to finalize enrollment activities.

• Address fundamental program inquiries and assist in coordinating access to therapies.

• Manage inbound phone queues and general program queries.

• Assess eligibility for support programs such as Copay, Patient Assistance Program, and Medicaid.

• Execute pharmacy triage and coordination tasks.

• Process wholesale orders efficiently.

• Follow up on incomplete information and manage prior authorization processes.

• Intake and report adverse events as instructed.

• Investigate and resolve claim denials or underpayments of claims.

• Collect information using authorized methods including phone, fax, mail, and online channels.

• Provide excellent customer service and address or escalate customer requests and complaints as necessary.

• Report trends or delays to program management.

• Ensure that program communications and correspondence adhere to quality standards.

• Coordinate with patients, healthcare providers, and internal shared services to gather comprehensive documentation.

• Analyze data and make informed decisions within established operating procedures.

• Operate from phone or system queues and undertake related duties as assigned.

⛳️ Requirements

• High school diploma or GED is mandatory.

• At least three (3) years of relevant and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration, or related fields.

• Equivalent combinations of education and experience will be taken into account.

• Strong background in customer service.

• Excellent verbal and written communication skills.

• Capability to establish effective internal and external working relationships.

• Strong interpersonal abilities.

• Basic analytical capabilities.

• Strong organizational skills with a keen attention to detail.

• General knowledge of the healthcare industry is preferred.

• Proficiency in Microsoft Excel, Outlook, and Word.

• Flexibility regarding schedule and hours is essential.

• Some travel may be necessary.

🏝️ Benefits

• Flexible schedule and hours.

• Equal employment opportunity protections.

• Reasonable accommodations for individuals with disabilities.