- Expiry Date: 17 August 2022
- Referral: firstname.lastname@example.org
Under the general supervision of an Operations Manager, they are considered a master of our services including but not limited to reimbursement activities, claim submission, claim status, collection activity, appeals, patient assistance, and copay assistance.
On a day-to-day basis they may be in contact with various customers of our services including but not limited to patients, providers, caregivers, and client brand teams.
Roles and Responsibilities:
Master of all standard and advanced services and willing to perform them as needed for the good of our patients.
Including but not limited to:
Billing and coding support
Claims assistance, tracking, and submission
Prior authorization assistance and tracking
Coordination of benefits
Benefit verification result call
Advanced alternate coverage research
Inbound Phone Queue/General Program Inquiries
Determination for support programs (Copay, PAP, Medicaid, etc.)
Pharmacy triage and coordination
Order processing for wholesale orders
Other follow-up activities (missing info, prior authorization, etc.)
Intakes and reports adverse events as directed.
Non-Clinical adherence services
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.).
Processes any necessary correspondence.
Coordinates with internal and external service providers to ensure services are performed in accordance with program policy and within
Provides training and support to internal associates.
Fields questions from program representatives and specialists.
Handles initial customer escalations.
Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate.
Independently and effectively resolves complex accounts with minimal supervision.
Maintains confidentiality in regard to all patient-sensitive information.
Works on complex issues where analysis of situations or data requires an in-depth evaluation of variable factors. Exercises judgment in selecting methods, techniques, and evaluation criteria for obtaining results. Networks with key contacts outside their own area of expertise.
Acts independently to determine methods and procedures on new or special assignments.
Performs related duties and special projects as assigned.
Ability to communicate effectively both orally and in writing.
Ability to build productive internal/external working relationships.
Advanced interpersonal skills.
Strong mathematical skills.
Basic analytical skills.
Advanced organizational skills and attention to detail.
Extensive knowledge of pharmacy operations and medical claims.
Excellent use of medical industry vernacular.
General knowledge of health care billing is required. Advanced knowledge is preferred.
Advanced use of MS Excel, Outlook, and Word.
Developing professional expertise; applying company policies and procedures to resolve a variety of issues.
A high school diploma or GED is required.
Requires broad training in fields such as business administration, accounting, computer sciences, medical billing and coding, customer service, or similar vocations generally obtained through completion of a two-year associate’s degree program, technical vocational training, or equivalent combination of experience and education.
Five years (5) + years of directly related and progressively responsible experience required.
A two-year degree can be used in lieu of 2 years of the experience requirement, and a four-year degree in lieu of 4 years of experience.
Four-year degree preferred.
About ASK: ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities.
ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.