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Administrative Assistant

Administrative Assistant

Job Title:Sr Reimbursement SpecialistJob Summary:TheSr. Reimbursement Specialist/Case Managerstrives to eliminate barriers to reimbursement and access in patients with complex and rare medical conditions. The Sr. Reimbursement Specialist, reporting to the Program Manager or Program Supervisor, navigates patient's healthcare insurance, performs administrative functions and interacts with key stakeholders in a call-center environment.Reimbursement specialists require personal integrity, strong empathy, a high level of accuracy and superb attention to detail.Responsibilities: (Duties may include, but not limited to all or some of the following) Conducts medical and pharmacy benefit insurance verifications and investigations for commercial and government payers Builds relationships with patients, caregivers, HCSs, and Sales Team to collect / share information and coordinate participation in the program Communicates with insurance companies, and third-party vendors to collect / share information and coordinate participation in the program Researches available disease-specific information in the assigned region: events, activities, resources, support groups, etc. Handles complex calls in a call-center environment Communicates with internal and external departments to facilitate coordination of information / resources Reports Adverse Events (AE) and Product Quality Complaints (PQC), as required and as per policy Strictly adheres to Standard Operating Procedures (SOPs) Accurately interprets patient insurance, prescription and other health-related documentation, as needed Validates and enters prescription orders, as appropriate Completes casework in a timely manner with consistent follow-up as the accountable case manager Maintains patient confidentiality Advocates on behalf of the patient to problem-solve any issues or obtain necessary information Understands prescription drug benefit management techniques including Formularies, Prior Authorizations, etc. Performs clerical and administrative functions such as mailing and faxing correspondence, data entry, scheduling, etc. Acquire/Exhibit/Maintain subject matter expertise in the area of the liver disease, including but not limited to the condition, treatment, community of patients and caregivers, activities and events offered throughout the country, etc., to ensure staff is providing the appropriate support / service(s) Apply subject matter expertise to drive program offeringsQualifications: Preferred experience: Social workers Patient Advocates Case workers / Case managers Buy and bill background Prior experience with scheduling patients Knowledge of Medical Terminology Working knowledge or experience with resolving drug reimbursement issues Knowledge of HCPCS, CPT and ICD-9/10 billing and/or coding Certification as Pharmacy Technician is plus Knowledge of US private and government payers Working knowledge of Microsoft Office (Word, Excel, Outlook)Skilled Required: Curiosity Empathy Problem Solving Swift Investigation Initiative Analytics Effective Listening Elaborate Thinking Excellent Communication Skills (oral and written) Use of / Access to Resources Bi-lingual (English / Spanish - Native) Ability to Present and Facilitate Customer focused Fast and accurate data entry Clear, pleasant speaking voice Ability to handle multiple tasks and troubleshoot issues Ability to work with little or no supervision Ability to adapt quickly to changing environment Team player/consensus builder Ability to interact with a diverse group Project management skills Ability to calculate figures such as discounts and percentages Able to work a rotational shift between the hours of 8am and 6pm- Mon to FriEducation Bachelor's degree preferred Associates degree or equivalent work experience is required 3-5 years in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, medical office, or related similar field 1+ years within Specialty Medical Practice - ie. GI, infusion, oncology, eye care?BenefitsMedical, Dental, and Vision Insurance401K Plan with Company MatchLife and AD&D Insurance

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