Position Summary:
We are seeking a dedicated and compassionate Care Coordinator (CC) to provide exceptional customer service and case coordination. In this role, you will assist members in accessing financial assistance programs for their prescribed medications. You will serve as a crucial point of contact, ensuring members receive the support they need by collaborating with pharmacies, healthcare providers, financial assistance programs, and insurance partners. The Care Coordinator will also be responsible for ensuring that members’ medication shipments are confirmed and will help facilitate communication between members, healthcare providers, and various stakeholders.
Key Responsibilities:
- Member Eligibility & Advocacy: Ensure that plan members meet eligibility requirements and serve as their primary point of contact throughout the care process.
- Relationship Building: Act as an advocate for plan members, fostering strong, collaborative relationships between members, healthcare providers, and patient assistance program representatives.
- Case Documentation: Accurately document all member interactions, including communications with healthcare providers, pharmacies, and financial assistance entities, in the Customer Relationship Management (CRM) system in a timely manner.
- Exceptional Customer Service: Deliver outstanding service to both internal and external customers, addressing requests promptly and efficiently. Escalate complaints when necessary, ensuring resolution.
- Customer Experience Excellence: Review pending activities, events, and specific customer requests to guarantee that all interactions meet the highest standards of service.
- System Expertise: Demonstrate a thorough understanding of the company’s member database, including case statuses, data elements, and documentation requirements, while ensuring alignment with company metrics.
- Financial Assistance Coordination: Research and identify financial assistance programs available for specialty medications prescribed to active members. Assist members and healthcare providers in completing all necessary forms and applications for these programs.
- Cross-functional Collaboration: Occasionally work with Pharmacy Benefit Managers (PBMs), payers, and insurance partners to gather essential information and support members’ needs.
Preferred Qualifications:
- At least 1 year of experience in customer service, healthcare reimbursement, or pharmaceutical settings
- Exceptional written and verbal communication skills
- Strong multitasking abilities with a high level of attention to detail
- Pharmacy Technician experience is encouraged
- Insurance verification experience is preferred
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. Equal Opportunity Employer/Veterans/Disabled.
