Bilingual Senior Caseworker supporting patients' reimbursement coverage options and managing complex casework. Working with healthcare professionals and coordinating patient care services.
Responsibilities
Working closely with assigned patients to identify various reimbursement coverage options and investigate financial options for those without insurance.
Assist with the coaching and mentoring of existing team members.
Manage a patient caseload larger than their caseworker counterparts.
Be a reimbursement expert in assigned caseload territory.
Provide other caseworker(s) assistance with complex reimbursement, insurance, benefit investigation, special authorization, and appeal requests.
Participate in special projects as assigned by the Program Manager.
Provide daily support to Associate Program Manager(s).
Assist management with various reports and program related tasks.
Work with management to develop program protocol and SOP for Caseworker role.
Lead training of new caseworkers, including but not limited to shadowing & call monitoring.
Interact with insurance companies, physician's offices, and healthcare professionals to provide optimal reimbursement support.
Assist the patient with Clinic and Pharmacy selections, and schedule patient appointments.
Generate drug orders ensuring that required information is faxed to the pharmacy and related parties.
Adhere to the general company processes.
Requirements
A minimum of two (2) years experience in customer service
Experience in medical, pharmaceutical and/or insurance industry is an asset
Bilingual in French and English: written and verbal is an asset
Highly organized with strong attention to detail
Strong proficiency in Microsoft applications (Outlook, Word, Excel & PowerPoint)
Flexibility in working shifts (hours of operation are 8 am - 8pm)
Ability to apply critical thinking skills to solution problems
Experience working in a call center environment an asset
Strong communication and interpersonal skills: written and verbal including effective phone etiquette to diverse audiences i.e. internal, healthcare professionals and patients
Proven ability to manage time, set priorities and multi-task to meet various competing work deadlines
Minimum University Degree in a related field or equivalent.
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