Cary, NC

RemX is accepting applications for NEW and EXPERIENCED talent for our Cary NC client. The Patient Support Coordinator is responsible for performing the adjudication, refill management, and delivery coordination functions in accordance with company policies and procedures.

RESPONSIBILITIES 

• Communicate with clinicians regarding patient refills and patient concerns so that all information included in the patient’s profile is accurate and up-to-date.
• Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner.
• Update concise progress notes to ensure other roles within the workflow are able to quickly assess the status of the referral.
• Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan.
• Answer patient questions and concerns and transfer to the clinical team when appropriate.
• Identify and report adverse events and product complaints to clinicians to ensure patient’s safety.
• Refer patients to the Patient Benefit team for assistance with prior authorizations.
• Initiate requests and receive refill prescriptions from providers to ensure patient’s therapy is continued without lapse.
• Accurately documenting customized services being provided in patient’s progress so that the fulfillment and distribution teams are aware of additional supplies to package.

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RemX is accepting applications for NEW and EXPERIENCED talent for our Cary NC client. The Intake Customer Service Representative is responsible for a variety of tasks requiring documentation review, data entry, written communication and superb customer service. To be successful in this role, strong attention to detail, accuracy, meeting established metrics and service levels, as well as compliance with regulatory standards (HIPPA) must be maintained.

Key Responsibilities: 

• Establish patient cases using information received via fax, phone or electronically.
• Perform accurate and timely data entry of patient information received via patient referrals.  
• Use all available resources to complete necessary tasks.
• Send outbound correspondence to physicians related to cases and services to be provided.
• Communicate with physicians and/or patients to ensure all necessary information has been received to move forward with processing requested services.
• Communicate with team members to ensure accurate patient processing within servicing requirements.
• Accurately complete assigned tasks and manage patient and physician follow-ups to ensure that they are performed timely.   
• Provide supplemental inbound Customer Service support as needed.
• Comply with all HIPPA requirements.

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RemX is seeking NEW and EXPERIENCED talent for our Cary NC client. The Reimbursement Specialist position requires that candidates be able to work any 8 hour shift Monday - Friday between the hours of 8am to 8pm. This is a very fast paced and high volume call center environment that provides program specific access and reimbursement support to patients, healthcare providers, and manufacturer representatives. 

Position Description

• Will frequently interact via telephone with commercial payers to conduct benefits verification.
• Works daily with commercial payers to  ensure appropriate coverage and reimbursement in a variety of therapeutic areas.
• Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits.
• Obtains payer specific prior authorization procedures and documentation requirements and share overall benefits verification results with healthcare providers and patients.
• A general understanding of Medicare and Medicaid programs is desired.

Key Responsibilities

1. Contact payers to verify patient eligibility and product specific coverage information. 
2. Assist patients and physicians with prior authorization,appeal management, nurse training and home health administration.
3. Interface with physicians, patients, and manufacturer representatives to obtain and provide drug specific coverage information.
4. Provide support and screening for patient assistance program and co-pay offerings.
5. Conduct research to identify appropriate alternate funding sources and make recommendation
6. Provide accurate and timely follow-up to all reimbursement inquires in accordance with program guidelines.
7. Ensure that the intake information is entered accurately and completely in order to perform all reimbursement research.
8. Research and compile payer specific information for reimbursement database.
9. Complete end to end processing of new referrals and re-enrollments
10. Follow program cadence for outreach to patients and health care providers to ensure patient can start therapy on time.
11. Complete healthcare provider's credentialing for online portal access to HCP and office staff.

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