JPAP HEALTHCARE COORDINATOR

Description

• Care Coordinator may be regionally aligned and will serve as an expert on all aspects of benefit coordination, and other forms of available support and will be responsible for handling healthcare provider and/or patient interactions
• May serve as an advocate to patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy
• Establishes relationships, develop trust, and maintain rapport with healthcare providers and/or patients
• Serves as point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
• Strong working knowledge and ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B
• Acts as an assigned liaison to client contacts (e.g., regional contact for sales representatives)
• Maintains records in accordance with applicable standards and regulations to the programs/promotion
• Follows program guidelines and escalates complex cases according to SOPs, Call Guides, and other program materials.
• Liaison between Program Management, other internal stakeholders, and healthcare providers
• Works with all levels of Program Management on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction, coordination challenges and program effectiveness
• Understands the nature of the disease states of patients of the program
• Maintains a high level of ethical and professional conduct regarding confidentiality and privacy

Skills

Prior authorization, Pharmacy, Medicare, Insurance verification, reimbursement, Care coordination, insurance billing, Health care, Data entry, Insurance, Call center, Medical terminology, Patient registration, Claim, Case management

Additional Skills & Qualifications

Knowledge in understanding insurance as it applies to reimbursement.

Experience speaking with patients and providers.

Experience and knowledge in Insurance reimbursement

Previous experience working through reverification with other programs/organizations.

Understanding of Free Goods programs

Well rounded in medical and pharmacy benefits/insurance

Must be Technology savvy and proficient in all Microsoft tools.

Experience Level

Expert Level