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.
Bilingual Retention Agent providing customer service and retention for Manulife. Responsible for inbound/outbound calls and sales applications in English and French.
New Business Coordinator at Manulife providing proactive support to corporate account offices and clients in the insurance application process. Building relationships and ensuring efficient processing of applications.
Patient Services Specialist providing administrative and counseling support for drug reimbursement at McKesson. Collaborating with patients, insurers, and healthcare professionals on a daily basis.
Bilingual Patient Care Coordinator managing all facets of patient coordination for Sentrex's treatment clinics. Ensuring timely access to treatment through appointment scheduling and liaison activities.
Contract Services Specialist at Manulife providing transaction processing support and excellent service to clients. Collaborating across teams and improving service efficiency while managing client inquiries.
Bilingual Case Manager managing patient enrollment and reimbursement processes for a pharmaceutical support provider in Canada. Collaborating with patients, insurers, and physicians to facilitate access to treatment.
Personal Support Worker providing support and care to residents in long - term care homes in Toronto. Delivering exceptional personal care and assisting with daily living activities in a multi - disciplinary team environment.
Bilingual Automotive Technical Specialist resolving claims and verifying technical vehicle conditions. Role involves hands - on diagnostics and customer relations in the automotive arena.
Lead Senior Complaint Consultant handling complex customer complaints for Allstate Insurance. Focused on process improvements, teamwork, and compliance in complaint management.
Indigenous Relations Advisor fostering relationships with Indigenous communities in Quebec and Atlantic Canada. Collaborating internally to support engagement initiatives and uphold compliance.