Reimbursement Care Coordinator

Description

JOB DESCRIPTION Job Title: Reimbursement Care Coordinator (“RCC”) Position Summary: Under the supervision of the Reimbursement Care Coordinator Manager, the RCC is responsible for customer service and case coordination. This position will help plan members access financial assistance programs. The RCC will follow up with members, pharmacies, health care providers and/or financial assistance programs to confirm shipment/receipt of drug shipments. From time to time, the RCC will be in contact with PBMs and Payers (Funds, Plan Sponsors, Insurers) to gather information and assist plan members. Key Responsibilities: - Ensure that plan members meet plan eligibility requirements - Act as primary point of contact for plan members - Serve as plan member advocate and enhance the collaborative relationship between the plan member, health care provider, and patient assistance program representatives - Document/record all interactions with members, health care providers, pharmacies, and financial assistance entities in the Customer Relationship Manager software (“CRM”) in a timely manner - Provide exceptional customer service to internal and external customers; resolve any customer requests in a timely and accurate manner; escalates complaints accordingly - Review pending activities/events and specific customer requests to ensure excellent customer service and customer experience - Demonstrate proficiency and full understanding of the Company plan member database including data elements, definition of case statuses and outcomes, case documentation requirements and the importance of meeting company metrics - Research and identify available financial assistance programs for specialty drugs that are prescribed for active members - Coordinate access to patient assistance programs; provide assistance to plan members and physician staff to complete all necessary financial assistance program forms and applications in a timely manner - Coordinate delivery and verify receipt of financial assistance forms and applications to plan members, physician offices, and financial assistance programs - Verify drug dispenses to members and compile audit trail of source documents and information for each dispense - Report any financial assistance program trends to supervisor - Communicate with plan member’s health plan sponsor, Fund, or PBM as needed - Recommend improved processes and management methods to generate workflow optimization - Perform such other duties as needed or assigned by management Minimum Requirements: • Minimum 3 years customer service experience, healthcare reimbursement and/or pharmaceutical experience preferred • Excellent written and oral communication skills • Ability to multi-task and handle consistent workflow • Time management and prioritization skills • Computer, email and MS Office competency Supervisor/Reporting Structure: