Program Specialist II

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

📋 Description

• Deliver personalized and dedicated support to both patients and healthcare providers through phone and online portals.

• Investigate and respond to inquiries regarding insurance benefits, coverage details, and out-of-pocket expenses.

• Assist with various financial processes, including payments, reimbursements, payment denials, appeals, prior authorization, and medical necessity evaluations.

• Conduct outbound calls to gather additional information as needed.

• Seek alternative reimbursement resources and help eligible patients with their enrollment process.

• Communicate with customers, sales representatives, and business partners, ensuring timely follow-up on requests.

• Manage orders, modify existing orders, track shipments, and keep detailed customer notes, logs, and records.

• Process patient assistance applications in accordance with program-specific business rules.

• Serve as the main contact for healthcare providers to gather patient enrollment and insurance information.

• Adhere to company and client policies and procedures diligently.

• Complete various assigned tasks and projects as required.

⛳️ Requirements

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

• Exceptional oral, written, and interpersonal communication abilities.

• Proven capability to multitask effectively.

• Highly accurate and detail-oriented.

• Ability to work independently while also being an effective team player.

• Comfortable working in a fast-paced, metric-driven environment while maintaining a patient-centered approach.

• Strong computer proficiency, with practical knowledge of Microsoft Word, Excel, and PowerPoint.

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

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

• Experience in medical billing and coding is preferred.

🏝️ Benefits

• Competitive salary.

• Options for remote work.

• Reasonable accommodations for individuals with disabilities.

• Commitment to equal opportunity employment.