Program Specialist II

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

📋 Description

• Deliver dedicated and personalized support to patients and doctors via phone and online portal.

• Investigate insurance benefits, coverage, and out-of-pocket expenses.

• Assist with payments, reimbursements, denials, and appeals processes.

• Make outbound calls to gather additional information from customers.

• Support prior authorization, medical necessity, benefit verification, and prior authorization assistance.

• Explore alternative reimbursement resources, including state and federal assistance programs.

• Aid qualified patients with the enrollment process.

• Address inquiries from customers, sales representatives, and business partners.

• Process orders, modify orders, and maintain customer notes; keep logs and records updated.

• Handle patient assistance applications in accordance with program business rules.

• Serve as the primary contact for healthcare providers seeking patient enrollment and insurance details.

• Execute additional assigned tasks and projects as needed.

⛳️ Requirements

• Must be available between 8:00 AM and 8:00 PM EST, depending on program and business requirements.

• Availability on weekends is necessary, including shifts on Saturdays and Sundays.

• High School Diploma with 4 years of experience in a healthcare environment, or an Associate’s Degree with 2 years of experience in a healthcare setting.

• Exceptional oral, written, and interpersonal communication skills.

• Capability to multitask effectively.

• Positive and proactive attitude.

• Strong attention to accuracy and detail.

• Ability to work autonomously as well as collaboratively within a team.

• Capacity to thrive in a fast-paced, metric-driven environment while maintaining a patient-centric approach.

• Proficient computer skills with a working knowledge of Microsoft Word, Excel, and PowerPoint.

• Excellent attendance record.

• Experience in customer service and/or call center environments is preferred.

• Previous experience in patient assistance, reimbursement, and/or pharmacy benefit management is preferred.

• Experience in medical billing and coding is preferred.

🏝️ Benefits

• Option for remote work.

• Competitive salaries and comprehensive benefits.

• Reasonable accommodations provided for individuals with disabilities.

• Commitment to being an equal opportunity employer.

• Strong dedication to diversity, equity, and inclusion.