Senior Caseworker

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

📋 Description

• Identify options for reimbursement coverage and explore financial solutions for patients without insurance.

• Coach and mentor current team members to enhance performance.

• Handle a larger patient caseload compared to caseworker peers.

• Serve as a reimbursement authority for the designated caseload region.

• Support caseworkers with intricate reimbursement issues, insurance inquiries, benefit investigations, special authorizations, and appeal requests.

• Engage in special projects assigned by the Program Manager.

• Provide daily assistance to Associate Program Managers.

• Aid management with reporting and program-related responsibilities.

• Develop program protocols and standard operating procedures for the Caseworker position.

• Facilitate training for new caseworkers, including shadowing and call monitoring activities.

• Collaborate with insurance companies, medical offices, and healthcare professionals.

• Guide patients in selecting clinics and pharmacies and scheduling appointments.

• Create drug orders and transmit necessary information to pharmacies and relevant stakeholders.

• Offer telephonic support for patients, healthcare providers, and funding organizations.

• Implement case-management protocols, encompassing clinical oversight, data collection, patient follow-up, compliance monitoring, therapy disruption oversight, adverse event reporting, and coordination with primary healthcare providers.

• Execute pharmaceutical and biotechnology market research initiatives.

• Make outbound calls as part of patient support programs.

• Record activities in program-specific databases.

• Attend refresher and specialized training courses.

• Communicate updates on case management during absences.

• Report adverse events to designated units/departments.

• Execute additional duties as necessary.

⛳️ Requirements

• At least two (2) years of experience in customer service.

• A minimum of 2 years of experience in a patient support program.

• Experience in the medical, pharmaceutical, and/or insurance sectors is advantageous.

• Call center experience is considered a plus.

• Highly organized with a keen attention to detail.

• Strong proficiency in Microsoft Outlook, Word, Excel, and PowerPoint.

• Flexibility to work shifts; operational hours are 8 am to 8 pm.

• Ability to utilize critical thinking skills to address problems.

• Excellent written and verbal communication skills, with effective phone etiquette.

• Proven capability to manage time, establish priorities, and multitask.

• Minimum of a University Degree in a relevant field or equivalent experience.

• Strong work ethic, reliability, and initiative to acquire new skills.

• Advanced understanding of the pharmaceutical distribution sector.

• Familiarity with automated warehouse operating systems.

• Strong business and financial acumen.

• Excellent analytical and mathematical abilities.

• Capacity to thrive in a fast-paced environment and consistently meet deadlines.

• Fully bilingual in oral and written communication.

• Effective interpersonal, leadership, organizational, and problem-solving skills.

• Outstanding leadership capabilities and training proficiency.

• Comprehensive knowledge of patient support programs.

• Responsible, dependable, and punctual.

• Experience in resolving complex issues.

• Strong technical capabilities and rapid adaptability to new software/databases.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Backup dependent care services.

• Adoption assistance programs.

• Infertility coverage options.

• Support for family building initiatives.

• Solutions for behavioral health needs.

• Paid parental leave.

• Paid caregiver leave.

• Access to training programs.

• Resources for professional development.

• Mentorship opportunities.

• Employee resource groups.

• Volunteering opportunities.

• Reasonable accommodations during the employment process and throughout employment.