Benefit Specialist

Our Company: PharmaCord is a leading provider in specialty drug patient support services. We are committed to enhancing the patient experience on therapy by providing them with compassionate support throughout their journey to better health.

We accomplish this through our world class technology and our talented team of benefit specialists, nurses, pharmacists, case managers, data scientists, pharmacy techs, program managers, and other incredibly talented team members. We are PharmaCord, a purpose-driven organization on a rapid growth journey. For additional information about our Company, visit our careers page at www.pharmacord.com/careers

Our Team: Our teams at PharmaCord are highly motivated and passionate for providing the highest quality customer support to our patients. We look for individuals interested in growing with our company and working in an exciting, open and collegial work environment. 

PharmaCord is seeking an exceptional Benefits Specialist who will provide in-depth knowledge of our client programs by working directly with patients, healthcare providers, and insurance companies to answer inquiries, process service requests, assess benefits coverage, and manage through barriers, in a compliant manner, that stand in the way of patients and their access to therapy. The Benefits Specialist works in a dynamic and compassionate customer service role providing telephonic and web-based, where applicable, customer service support.

A typical day in the life of a Benefits Specialist will include the following:

The responsibilities include, but are not limited to the following:

·        Benefit Verification:

o  Performing patient level benefits verifications as applicable for all major medical and pharmacy benefits plans.

o  Completion of the template forms that provide patient level benefits Coverage Determination Summary.

o  Coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance.

·        Patient Assistance:

o  Review of patient assistance enrollment forms and any supporting documentation to assess patient eligibility for participation as per SOPs and program guidelines.

o  Determination of patient’s eligibility based upon program criteria for qualification.

o  Communicating the patient’s eligibility to the patient, healthcare provider, and/or consignment pharmacy.

·        Answer and assist inbound callers through resolution utilizing answers to frequently asked questions or by warm transferring callers to other appropriate individuals.

·        Actively listen to each customer, assess needs, and respond with demonstrated patience and courtesy.

·        Review and identification of information that is missing and/or incorrect within program service requests/program applications.

·        Reporting of Adverse Events/ Product Complaint inquiries received in accordance with SOP and good manufacturer practices.

·        Provides timely feedback to the company regarding service failures or customer concerns

·        Effectively uses our internal technology platform, CORscend, to complete claims processing and keep workflows moving.

·        Communicate with key medical practice accounts, sales representatives regarding the status of cases. Provide consultative services where issues arise on how obstacles can be overcome to get patient on paid therapy.

·        Benefits Specialists are expected to be patient focused and committed to providing the highest quality customer service all while maintaining a sense of compliance and commitment to abiding by company policies and procedures.

This job might be for you if (must have requirements of the role):

The candidate must possess the following personal attributes:

·        Service minded; focus on recognizing and meeting the needs of others (especially patients and care partners)

·        Ability to handle personal health information with confidentiality

·        Commitment to honesty and integrity

·        Professionalism and a strong sense of proper business and customer service etiquette

·        Clear verbal and written communication skills

·        Accountability for results

·        Ability to plan and prioritize tasks and strong attention to detail

·        Proficient emotional intelligence (ability to recognize emotions and their effects)

·        Ability to manage disruptive impulses and handle potentially stressful customer interactions

·        Proficient computer skills

·        Adaptability to change

·        Personal initiative and commitment to team and organizational goals

·        Ability to work effectively within a team

·        A positive attitude!

Education and Experience:

·        High School diploma or equivalent is required; Bachelor’s degree is preferred!

·        6 months customer service experience, payer benefits experience (reimbursement, prior authorization, etc.), healthcare industry experience or healthcare related certification, license, or equivalent coursework is strongly preferred

·        Bilingual is a plus

Physical Demands:

·        While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy.

·        Ability to travel as needed

Work Schedule & Environment

·        This is a full-time or part-time position (depending on business need). Standard shifts include 8am – 4:30pm ET, 9:00am- 5:30pm, 9:30am – 6pm or 11:30am – 8pm and will depend on business need. 

·        This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.

·        Due to investment in program specific training, candidates are expected to maintain role for a minimum of 6 months, especially within a client-facing role, prior to being considered eligible for lateral or promotion level move. PharmaCord is committed to creating a strong company culture that values collaboration, employee development, and promotion from within. Exceptions will be reviewed on a case-by-case basis to assess business need and service impact.

Once you land this position, you’ll get to enjoy:

·        A compassionate patient services-oriented environment

·        Benefits of a dynamic and growing organization

·        A challenging, hands on role that will have real impact on the business

·        Competitive hourly compensation

·        Comprehensive benefits package

Any offer of employment is contingent on completion of a background check and drug screen to company standard. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

At PharmaCord, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer.

Want to learn more about us? Find us on LinkedIn, Glassdoor, Twitter & Facebook!