Customer Service Representative, Healthcare
Imagenet LLC
Regional Patient Case Manager
RareMed Solutions
full-time
Posted on:
Location: Pennsylvania • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
About the role
- Primary point of contact and case manager for client and customer needs, inquiries and escalations
- Coordinate all patient and relevant HCP-related support and access services across functions (patient journey calls, benefits verification, prior authorization and appeals, triage to specialty pharmacy, follow ups)
- Maintain clear, concise, and accurate documentation on all accounts according to Standard Operating Procedures
- Conduct initial welcome calls to patients and provide ongoing targeted outreach and support
- Maintain frequent touchpoints with providers and patients to communicate progress
- Work independently to complete program enrollment, answer inquiries, and coordinate access to free 14-Day Supply Program
- Apply defined business rules to qualify patients for manufacturer supported programs
- Provide support, education, and status updates to regionally aligned field teams, HCP offices, and patients
- Process PAP requests and PAP re-approval verification for continued eligibility
- Refer patients to third-party or foundation programs per business rules
- Identify and document adverse events, product complaints, and LTC cases and triage appropriately
- Manage assigned territory, prioritize workload, and make decisions for timely case resolution
- Collaborate with field teams on account progression and case recovery efforts
- Coordinate with manufacturer representatives, HCP offices and other personnel on complex cases requiring strategic intervention
- Maintain frequent phone/email contact with internal operational staff and utilize outbound faxes, email alerts, and mailings per program guidelines
- Demonstrate strong compliance mindset and understanding of patient privacy laws
- Provide concierge-level service to internal and external customers and escalate appropriately
- Flexible schedule may be required; shifts between 8:00AM and 8:00PM EST, Monday through Friday
- Other duties as assigned
Requirements
- High school diploma plus 2+ years recent case management experience
- Previous 2+ years in a pharmacy, healthcare setting, and/or insurance background
- Advanced knowledge and experience in healthcare setting
- Strong interpersonal skills; ability to communicate effectively both orally and in writing with a focus on customer satisfaction
- Empathy, drive and commitment to exceptional service
- Ability to build productive internal/external working relationships
- Ability to independently manage case load, prioritize work, and use time management skills to meet deliverables
- Willingness to work shifts between 8:00AM and 8:00PM EST, Monday through Friday
- Employees must be within commuting distance to Pittsburgh, PA, and able to report to the office when needed
- Reliable internet access required when telecommuting
- Preferred: Undergraduate degree and/or equivalent work experience
- Preferred: Certified Pharmacy Technician (CPhT) or Case Management Experience
- Preferred: Bilingual Spanish speaking and writing is a plus
- Preferred: Strong analytical and organizational skills with meticulous attention to detail
- Preferred: Experience with benefit investigation and verification of prescription benefits
- Preferred: Working knowledge of Third-Party and other Foundation programs
- Preferred: Understanding of plan types – Government, Commercial, Medicaid, VA, Fed
- Preferred: Knowledge of insurance structure (ex PBM’s, major medical plans, co-pay assistance/cards)
- Preferred: Ability to proficiently use Microsoft Teams, Excel, Outlook and Word
