Senior Caseworker, Bilingual

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

📋 Description

• Collaborate closely with designated patients to explore various reimbursement coverage options and assess financial alternatives for those who are uninsured.

• Aid in the training and mentoring of current team members.

• Oversee a patient caseload that exceeds that of their caseworker peers.

• Serve as a reimbursement authority within the assigned caseload area.

• Assist other caseworkers with intricate reimbursement, insurance, benefit investigations, special authorizations, and appeal requests.

• Engage in special projects as delegated by the Program Manager.

• Provide daily assistance to Associate Program Manager(s).

• Support management with various reports and program-related duties.

• Collaborate with management to establish program protocols and SOPs for the Caseworker role.

• Together with management, lead the training of new caseworkers, including but not limited to shadowing and call monitoring.

• Frequently interact with insurance companies, physician offices, and healthcare professionals to ensure optimal reimbursement support.

• Guide patients in selecting Clinics and Pharmacies, and coordinate patient appointments.

• Generate drug orders, ensuring that necessary information is faxed to the pharmacy and related parties.

• Adhere to the standard company processes.

• Implement call-center initiatives by providing patients, healthcare professionals, and funding bodies with telephone support. Current assistance lines focus on: Funding and access issues, including private, public, and special access programs; Compliance programs.

• Administer and comply with case management protocols, including clinical monitoring, data collection, ongoing patient follow-up, compliance, therapy disruption/discontinuation monitoring, adverse event reporting, and liaison with primary healthcare providers; Execute pharmaceutical and biotechnology-related market research initiatives with physicians, patients, pharmacists, or other allied health professionals; All patient programs are based on casework methodologies and involve a significant amount of outbound calls.

• Record each activity in the program-specific database.

• Participate in ongoing refresher training and specialized training courses for specific products or programs as deemed necessary by the manager.

• Maintain clear communication with the manager, pod, and program-trained colleagues regarding case management during anticipated absences.

• Responsible for reporting all Adverse Events to the designated units/departments.

⛳️ Requirements

• At least two (2) years of experience in customer service; experience in the medical, pharmaceutical, and/or insurance sectors is an advantage.

• Bilingual in French and English: both written and verbal proficiency is a plus.

• Highly organized with a keen attention to detail.

• Strong proficiency in Microsoft applications (Outlook, Word, Excel & PowerPoint).

• Willingness to work flexible shifts (operating hours are from 8 am to 8 pm).

• Capability to apply critical thinking skills to resolve problems.

• Minimum of 2 years of experience in a patient support program.

• Experience in a call center environment is an asset.

• Excellent communication and interpersonal skills, both written and verbal, including effective phone etiquette for diverse audiences such as internal staff, healthcare professionals, and patients.

• Demonstrated ability to manage time effectively, prioritize tasks, and multitask to meet various competing deadlines.

• Minimum University Degree in a related field or equivalent experience.

🏝️ Benefits

• Medical, dental, and vision care.

• Comprehensive suite of benefits.

• Support for working families.

• Backup dependent care.

• Adoption assistance.

• Infertility coverage.

• Family building support.

• Behavioral health solutions.

• Paid parental leave.

• Paid caregiver leave.

• Variety of training programs.

• Professional development resources.

• Mentorship programs.

• Employee resource groups.

• Volunteer activities.

• Inclusive culture.