Provide on-site and on-demand education for the office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include:
- Benefit Investigation / Prior Authorization Process
- Support Center Services
- Medicare and Commercial coverage
- Educate on the patient communication streams
- Case management
- Billing and coding updates
- Appropriate claims submission
- Specialty Pharmacy
- Medical Benefit Interpretation
- Understanding medical necessity
- Claims / Appeal assistance
- Information related to co-pay assistance programs
- Information related to patient assistance programs
Responsible for setting up appointments and completing out bound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.
Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
Research and compile provider / manufacturer representative specific information for reimbursement database.
Utilize internal resources to proactively address areas of opportunity related to the overall customer experience.
Utilize performance tracking tools & survey