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Patient Assistance Counselor III

Spectraforce Technologies
medical insurance
United States, Illinois, North Chicago
Jan 09, 2025
Job Title: Patient Assistance Counsellor III Location: Remote Duration: 06 Months The hours of operation are between 7am-7pm CST. Shift Timings: Training is 8:00 Am - 4:30 Pm CST (6- 10 Weeks) 10:30am-7pmCST is the most likely shift placement for after training but it is subject to change depending on the needs of the business. Purpose: The PAC will coordinate and review all required applications and financial documents, determine eligibility, when appropriate, and complete record documentation. The PAC will also investigate patients without insurance coverage, with limited benefit coverage, who are underinsured or have high out of pocket prescription and or medical expenses which may qualify them under the guidelines of the PAP program. Responsibilities: Access to a secure and private location to work from daily. Access to fast and secure internet connection. Maintain a professional dress code and appearance each day. Balance attendance, understanding this is the number one reason agents contracts are not extended or termed early. This includes being on time for their shift and returning from lunch as well. Must have thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations. Demonstrated ability to lead and participate within a team, manage multiple priorities, and meet associated timelines while maintaining accuracy. Demonstrated strong, accurate technical skills. Must be detail oriented. Professional written and verbal communication skills required. Ability to always maintain a positive service image even when dealing with challenging issues and unsatisfied customers. 5+ years of experience in regulated benefits environment Education & experience requirement High School Diploma or equivalent required. College or a 2-year associate degree is preferred. Experience of 5 to 7 years within a healthcare provider, PBM, Specialty Pharmacy or Retail/Mail Order Pharmacy setting, Strong core insurance (Medical and Pharmacy Benefit) knowledge, High quality customer service, knowledge of online verification systems, or similar experience required. Pharmacy Tech may be required.