The Re-Enrollment Advocate supports the annual enrollment process for patients accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions. This role is a seasonal call center position. Schedules are flexible. Training and work is onsite in our call center. Work hours range from 8am to 8pm, Monday through Friday.
Responsibilities:
- Review and process patients' enrollment forms to the Patient Assistance Program (PAP)
- Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.
- Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process
- Schedule treatments to be sent to the patient or patient's healthcare provider
- Support inbound and outbound phone lines for the PAP program
- Communicate daily with patient/authorized representative on eligibility based on PAP criteria and healthcare providers to manage expectations.
- Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer's PAP program.
- Prioritize workload to ensure patients' enrollments are processed within specified timeframe
- Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician's office staff.
- Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates and caregivers.
- Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.
- Execute day-to-day operations specific to the assigned program(s).
- Maintain patient confidentiality at all times.
The above duties are meant to be representative of the position and not all-inclusive.
Qualifications:
REQUIRED EDUCATION AND EXPERIENCE :
- High school diploma or equivalent
- Must have proven ability to provide consistently high-quality of service
- Ability to work through the project dates: Nov 1st to March 31st. Training begins mid-September
- Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers
- Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field
- Six (6) months of work experience in a call center environment.
- Experience with HIPAA and patient services
- Bi-lingual, English and Spanish
- Demonstrated empathy and compassion
- Excellent verbal and written communication skills
- Excellent organization skills and detail oriented
- Balance multiple priorities to meet expected response deadlines
- Adaptable, flexible and readily adjust to changing situations
- Ability to work independently and as a member of a team
- Ability to comprehend and apply basic math principles
- Ability to apply logical thinking when evaluating practical problems
- Ability to present information and respond to questions from stakeholders
- Ability to interact with a diverse group
- Ability to listen and demonstrate a high degree of empathy
- Demonstrated computer skills includes Microsoft Word, Excel, and Outlook
- Display tact and diplomacy in response to unfavorable or negative situations
- Demonstrated sensitivity and understanding when speaking with patients
- Demonstrated passion for speaking with people in an outgoing way
- Location of job activities 100% inside
- Extensive manual dexterity (keyboarding, mouse, phone)
- Constant use of phone for communication
- Noise and/or vibrations exposure
- Frequently reach (overhead), handle, and feel with hands and arms
- Sit for prolonged periods of time
- Occasionally stoop, kneel, and crouch
- Occasionally lift, carry, and move up to 25 pounds
COM051
Nesco Resource offers a comprehensive benefits package for our associates, which includes a MEC (Minimum Essential Coverage) plan that encompasses Medical, Vision, Dental, 401K, and EAP (Employee Assistance Program) services.
Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.