Patient Services Representative

What are we looking for in our Patient Services Representative?

Russell Tobin & Associates is seeking  Patient Service Representatives for a Pharmaceutical corporation.

Pay: $17.00-$18.00/hr

Location: REMOTE

Summary: Team members will work interactively with patients and their healthcare providers to complete enrollment activities, answer basic program inquiries, and help coordinate access to therapies through the patient’s healthcare provider.

Key job responsibilities

• Billing and coding support
• Claims assistance, tracking and submission
• Prior authorization assistance and tracking
• Coordination of benefits
• Benefit verification result call, Welcome calls
• Advanced alternate coverage research, Appeals/Denials
• Inbound Phone Queue/General Program Inquires
• Determination for support programs (Copay, PAP, Medicaid, etc.) 
• Pharmacy triage and coordination
• Order processing for wholesale orders
• Intakes and reports adverse events as directed.
• Engages with manufacturer representatives around items like payer profiles, reimbursement trends, issues with specific offices etc.
• Responsible for coordination of services with field reimbursement teams and sales representatives.
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
• Independently analyzes, reports, resolves, and communicates any reimbursement trends/delays (e.g. billing denials, claim denials, pricing errors, payments, etc.). 6. Coordinates with internal and external service providers to ensure services are performed in accordance with program policy and within expected service level agreements (SLA).
• Provides training and support to internal associates.
• Fields questions from program representatives and specialist.
• Handles initial customer escalations.
• Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate. 

 Qualifications

• 5 years experience 
• Ability to communicate effectively both orally and in writing.
• Ability to build productive internal/external working relationships.
• Strong interpersonal skills.
• Strong mathematical skills.
• Strong organizational skills and attention to detail.
• General knowledge of accounting principles, pharmacy operations, and medical claims.
• General knowledge of health care billing preferred.
• Ability to proficiently use Microsoft Excel, Outlook and Word.
• Developing professional expertise; applies company policies and procedures to resolve a variety of issues.
  
  

Russell Tobin is a leading minority-owned professional and technical recruitment and staffing advisory organization.

We are comprised of specialized practices focusing on a variety of skill sets and industries. Having a depth and breadth of industry expertise, our subject matter experts are able to provide tailored and swift sourcing solutions to fulfill client hiring needs. In other words, we connect top talent with companies.

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Russell Tobin offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.

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Rate/Salary: 17.00-18.00