Payer Analyst
Job Description SummaryPosition
Summary:
In addition Senior Care Manager job duties, the Payer Analyst is also responsible for the following:
o Contacting insurance companies to obtain correct eligibility information & perform benefit investigations when neededo Copay assistance inquirieso Check prior authorization and/ or appeal status with the Specialty Pharmacy to ensure patient will receive injection in timely mannerThe Payer Analyst is also responsible for working directly with the Account Director to ensure Specialty Pharmacy process flows are being managed accordingly, assisting their Program Manager/Associate Director with any Specialty Pharmacy reporting, team support, special projects, scheduling, meetings, or Specialty Pharmacy escalations under the Managers direction or request.
The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position.
They are not intended to be an exhaustive list of the skills and abilities required to do the job.
AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.
Primary
Responsibilities:
1.
Responsible for answering in-bound calls and assisting stake holders with pharmacy related services2.
Obtain client information by answering telephone calls; interviewing clients; verifying information3.
Contact insurance companies for benefit investigation and coverage eligibility4.
Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs5.
Provide customers with courteous, friendly, fast and efficient service6.
Update job knowledge by participating in educational opportunities and training activities.
7.
Work efficiently both individually and within a team to accomplish required tasks8.
Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures9.
Assisting their Program Managers with any team reporting, team support, special projects, scheduling, meetings, or escalations under the Program Managers direction or request.
Required
Qualifications:
1.
Customer Service experience2.
High School Diploma or equivalent, some college preferred3.
Minimum one-year experience in medical billing, insurance verification, or similar related medical office experience4.
Previous data entry experience (minimum three months) and ability to type 30wpm+Preferred
Qualifications:
1.
Project Management experience2.
Bilingual (Spanish) highly desirable3.
Ability to use MS OfficeProfessional Competencies:
1.
Business Skills and Knowledgeo General ManagementDemonstrate analytic and problem-solving skills, and understand the impact of individualdecisions on other parts of the organization and the environment.
o Quality improvementApplication of techniques that continually improve the quality of care provided, patientsafety, organizational performance, and the financial health of the organization.
2.
Knowledge of the Health Care Environmento Health Care Systems and OrganizationsDemonstrate an understanding of how the various components of the health caresystem is organized and financed, and how they interact to deliver medical and healthcare.
o The Patient's PerspectiveUnderstand the patient experience, demonstrate a commitment to patients' rights andresponsibilities, and ensure that the organization provides a safe environment forpatients and their families.
3.
Communication and Relationship Managemento Relationship ManagementThe ability to build and maintain relationships with internal as well as externalstakeholders that are anchored in trust and where decision-making is shared.
o Communication SkillsCan utilize verbal, written and presentation skills to communicate anorganization's mission, vision, values and priorities to diverse audiences.
4.
Professionalismo The ability to align personal and organizational conduct with ethical and professional standardsthat include a responsibility to the patient and community, a service orientation, and acommitment to lifelong learning and improvement.
IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry.
We believe in pushing the boundaries of human science and data science to make the biggest impact possible - to help our customers create a healthier world.
Learn more athttps:
//jobs.
iqvia.
comWe are committed to providing equal employment opportunities for all, including veterans and candidates with disabilities.
https:
//jobs.
iqvia.
com/eoeIQVIA's ability to operate and provide certain services to customers and partners necessitates IQVIA and its employees meet specific requirements regarding COVID-19 vaccination status.
https:
//jobs.
iqvia.
com/covid-19-vaccine-statusThe potential base pay range for this role, when annualized, is $58,500.
00 - $87,700.
00.
The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time).
Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.
#J-18808-Ljbffr Recommended Skills Analytical Business Relationship Management Customer Service Data Entry Decision Making Ethics Estimated Salary: $20 to $28 per hour based on qualifications.
Summary:
In addition Senior Care Manager job duties, the Payer Analyst is also responsible for the following:
o Contacting insurance companies to obtain correct eligibility information & perform benefit investigations when neededo Copay assistance inquirieso Check prior authorization and/ or appeal status with the Specialty Pharmacy to ensure patient will receive injection in timely mannerThe Payer Analyst is also responsible for working directly with the Account Director to ensure Specialty Pharmacy process flows are being managed accordingly, assisting their Program Manager/Associate Director with any Specialty Pharmacy reporting, team support, special projects, scheduling, meetings, or Specialty Pharmacy escalations under the Managers direction or request.
The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position.
They are not intended to be an exhaustive list of the skills and abilities required to do the job.
AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.
Primary
Responsibilities:
1.
Responsible for answering in-bound calls and assisting stake holders with pharmacy related services2.
Obtain client information by answering telephone calls; interviewing clients; verifying information3.
Contact insurance companies for benefit investigation and coverage eligibility4.
Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs5.
Provide customers with courteous, friendly, fast and efficient service6.
Update job knowledge by participating in educational opportunities and training activities.
7.
Work efficiently both individually and within a team to accomplish required tasks8.
Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures9.
Assisting their Program Managers with any team reporting, team support, special projects, scheduling, meetings, or escalations under the Program Managers direction or request.
Required
Qualifications:
1.
Customer Service experience2.
High School Diploma or equivalent, some college preferred3.
Minimum one-year experience in medical billing, insurance verification, or similar related medical office experience4.
Previous data entry experience (minimum three months) and ability to type 30wpm+Preferred
Qualifications:
1.
Project Management experience2.
Bilingual (Spanish) highly desirable3.
Ability to use MS OfficeProfessional Competencies:
1.
Business Skills and Knowledgeo General ManagementDemonstrate analytic and problem-solving skills, and understand the impact of individualdecisions on other parts of the organization and the environment.
o Quality improvementApplication of techniques that continually improve the quality of care provided, patientsafety, organizational performance, and the financial health of the organization.
2.
Knowledge of the Health Care Environmento Health Care Systems and OrganizationsDemonstrate an understanding of how the various components of the health caresystem is organized and financed, and how they interact to deliver medical and healthcare.
o The Patient's PerspectiveUnderstand the patient experience, demonstrate a commitment to patients' rights andresponsibilities, and ensure that the organization provides a safe environment forpatients and their families.
3.
Communication and Relationship Managemento Relationship ManagementThe ability to build and maintain relationships with internal as well as externalstakeholders that are anchored in trust and where decision-making is shared.
o Communication SkillsCan utilize verbal, written and presentation skills to communicate anorganization's mission, vision, values and priorities to diverse audiences.
4.
Professionalismo The ability to align personal and organizational conduct with ethical and professional standardsthat include a responsibility to the patient and community, a service orientation, and acommitment to lifelong learning and improvement.
IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry.
We believe in pushing the boundaries of human science and data science to make the biggest impact possible - to help our customers create a healthier world.
Learn more athttps:
//jobs.
iqvia.
comWe are committed to providing equal employment opportunities for all, including veterans and candidates with disabilities.
https:
//jobs.
iqvia.
com/eoeIQVIA's ability to operate and provide certain services to customers and partners necessitates IQVIA and its employees meet specific requirements regarding COVID-19 vaccination status.
https:
//jobs.
iqvia.
com/covid-19-vaccine-statusThe potential base pay range for this role, when annualized, is $58,500.
00 - $87,700.
00.
The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time).
Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.
#J-18808-Ljbffr Recommended Skills Analytical Business Relationship Management Customer Service Data Entry Decision Making Ethics Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
