Remote - Payor-Partner Programs Specialist

Scope of Responsibilities: Works under general supervision. Follows standard procedures to accomplish assigned tasks. Assist in orienting and training employees Job Summary: Responsible for all aspects related to management of hub services relationships, entering of medication orders, and customer service for patients/providers in a call center environment. Provide direct support and serve as primary point of contact patients of designated third-party payers Follow customized patient support service models and programs to meet and exceed client expectationsFollow established protocol and non-standard service models to provide the highest quality of services to patientsServe as subject matter experts on the intricacies of selected payer partner programs and assist patients in ensuring the correct triage and handlingResponsible for assisting in the implementation of process improvement to ensure a streamlined patient relationship consistent with selected payer specifications. This may include accessing systems such as partner CRMs to investigate patient needs more fully.Responsible to receive triage patient calls from general call center for handling.Responsible for accurate selecting billing and shipping methods for incoming patient orders and setting up delivery of patient orders as necessaryCustomer service coverage for incoming calls and directing incoming calls to appropriate staff as neededDocument patient reported information into TherigySTMDocument and reporting information via McKesson EnterpriseRXDocument and research plan specific information in partner CRM/tools.Provides resolution to customer service issues to ensure member satisfactionWork with members to provide resolution to payment related issues on accounts/ordersMaintain and keep reasonable production as determined by supervisor May assist in orienting and training new employeesResponsible for completing all mandatory and regulatory training programsPerform other duties as assignedMay assist in training new employeesJob Skill Requirements: Broad knowledge of medications, physician orders, and pharmacy systemsEffective communication skills Outstanding customer service skillsExcellent organization skillsAbility to multitask and prioritize Excellent computer and keyboarding skillsEducational Requirements:Minimum: High School Diploma or GEDPreferred: Pharmacy technician or related certificationExperience: Past experience in a customer service-related fieldPreferred: 6 months experience in a call center environmentPreferred: 12 months experience as a pharmacy technicianCompensation$18.50 - 22.00 per hourThe final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.

Created: 2025-11-28