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    KP

    KPH Healthcare Services

    Healthcare

    Payor-Partner Program Specialist- Remote

    Syracuse, United StatesOn-SiteFull-time$18.5 – $22 / hourPosted 1mo ago
    All KPH Healthcare Services jobs

    Job description

    Overview

    Scope of Responsibilities: Works under general supervision. Follows standard procedures to accomplish assigned tasks. Assist in orienting and training employees

    Job Summary: Responsible for all aspects related to management of hub services relationships, entering of medication orders, and customer service for patients/providers in a call center environment.

    Responsibilities

    • Provide direct support and serve as primary point of contact patients of designated third-party payers
    • Follow customized patient support service models and programs to meet and exceed client expectations
    • Follow established protocol and non-standard service models to provide the highest quality of services to patients
    • Serve as subject matter experts on the intricacies of selected payer partner programs and assist patients in ensuring the correct triage and handling
    • Responsible for assisting in the implementation of process improvement to ensure a streamlined patient relationship consistent with selected payer specifications. This may include accessing systems such as partner CRMs to investigate patient needs more fully.
    • Responsible to receive triage patient calls from general call center for handling.
    • Responsible for accurate selecting billing and shipping methods for incoming patient orders and setting up delivery of patient orders as necessary
    • Customer service coverage for incoming calls and directing incoming calls to appropriate staff as needed
    • Document patient reported information into TherigySTM
    • Document and reporting information via McKesson EnterpriseRX
    • Document and research plan specific information in partner CRM/tools.
    • Provides resolution to customer service issues to ensure member satisfaction
    • Work with members to provide resolution to payment related issues on accounts/orders
    • Maintain and keep reasonable production as determined by supervisor
    • May assist in orienting and training new employees
    • Responsible for completing all mandatory and regulatory training programs
    • Perform other duties as assigned
    • May assist in training new employees

    Qualifications

    Job Skill Requirements:

    • Broad knowledge of medications, physician orders, and pharmacy systems
    • Effective communication skills
    • Outstanding customer service skills
    • Excellent organization skills
    • Ability to multitask and prioritize
    • Excellent computer and keyboarding skills

    Educational Requirements:

    • Minimum: High School Diploma or GED
    • Preferred: Pharmacy technician or related certification

    Experience: 

    • Past experience in a customer service-related field
    • Preferred: 12 months experience in a call center environment
    • Preferred: 24 months experience as a pharmacy technician

    Compensation

    $18.50 - 22.00 per hour

    The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.

    KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.

    Job details are sourced from the employer's original posting.

    Open job posting
    KP

    About the company

    KPH Healthcare Services

    KPH Healthcare Services is a leading provider of pharmacy and healthcare services.

    View all KPH Healthcare Services jobskphhealthcareservices.com
    Industry
    Healthcare
    Open roles
    221

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