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Patient Access and Reimbursement Specialist
A career with EMD Serono is an ongoing journey of discovery: our 57,000 people are shaping how the world lives, works and plays through next generation advancements in healthcare, life science and performance materials. For more than 350 years and across the world we have passionately pursued our curiosity to find novel and vibrant ways of enhancing the lives of others. EMD Serono is a business of Merck KGaA, Darmstadt, Germany.
The Patient Access and Reimbursement Specialist (PARS) plays an integral role within EMD Serono’s Patient Support Services Call Center, MS LifeLines (MSLL) as part of the overall Marketing function within the Neurology & Immunology Therapeutic area. This individual will be directly responsible for providing reimbursement assistance and support to patients in an assigned geography. The PARS serves as a regional subject matter expert and is knowledgeable about formulary status of EMD Serono products at the local level. All cases will be handled with personalized attention and the utmost confidentiality. In this role the individual will address reimbursement related inquiries, assess patients’ coverage options, provide eligibility and benefit verification, secure insurance authorizations, advocate for maximum reimbursement coverage and provide patient assistance for those in need of financial support.
- Consistently provide a high level of customer service to both internal (counterparts in nursing, field reimbursement, and support functions) and external customers as needed
- Maintain accountability for day-to-day patient reimbursement activities, workload and overall workflow
- Manage tasks and activities assigned by specific geographic territories to ensure a high level of patient and physician satisfaction
- Work collaboratively with assigned Patient Access Liaisons to secure coverage for EMD Serono products
- Work on patient’s behalf to identify and assess reimbursement coverage options for those with insurance and to coordinate and/or investigate financial options for those without insurance
- Work with physician offices and/or pharmacies to facilitate the process of obtaining prior authorization from third party payers to maximize patients’ access to treatment
- Monitor, follow-up with and record all insurance re-authorizations required by payers to help ensure compliance and continuity of treatment
- Help support the appeal process, with consent from the patient, caregiver and/or the provider
- Deliver presentations regarding reimbursement options to provider’s offices, specialty pharmacies and patient programs where appropriate
- Align with Market Access function and field reimbursement at the regional level to maintain a knowledge regarding Payors, Pharmacies and maintain a working knowledge regarding formulary opportunities or challenges
- Maintain database for recording, managing, and monitoring patient activities for those requiring reimbursement support
- Analyze data for reporting and trending and report to departmental manager
- Maintain a collaborative approach with members of call center team to offer the best possible outcome for all customers
- Demonstrate the utmost sensitivity and confidentiality of information while maintaining a high level of professionalism
- Assume additional projects on an as needed basis
- Continued education and training to maintain technical expertise in the assigned therapeutic area and to keep current on approved product information and promotional items
- Attendance of certain association meetings during the year to receive updated information or competitive review
This is an 11:30am to 8:00pm shift with occasional weekend shifts and overtime
Who you are:
- Bachelor’s degree in any discipline or Associate’s degree in any discipline with 1+ years’ experience in patient access, financial assistance or reimbursement roles within specialty pharmacy or High School diploma or equivalent with 5+ years’ experience in patient access, financial assistance, or reimbursement roles within specialty pharmacy.
- 2+ years working with computers with customer contact databases, Microsoft Office (Word, Excel, PowerPoint)
- Pharmacy technician experience preferably with patient interaction or educational support
- Bilingual capability
- Exceptional customer service and telephone skills
- 2+ years of Data Entry experience with accurate typing skills.
- Experience working with SalesForce
- Presentation skills and experience
- Ability to manage multiple and/or repetitive tasks coupled with working in a fast-paced environment
What we offer: With us, there are always opportunities to break new ground. We empower you to fulfil your ambitions, and our diverse businesses offer various career moves to seek new horizons. We trust you with responsibility early on and support you to draw your own career map that is responsive to your aspirations and priorities in life. Join us and bring your curiosity to life!
Curious? Apply and find more information at https://jobs.vibrantm.com
The Company is an Equal Employment Opportunity employer. No employee or applicant for employment will be discriminated against on the basis of race, color, religion, age, sex, sexual orientation, national origin, ancestry, disability, military or veteran status, genetic information, gender identity, transgender status, marital status, or any other classification protected by applicable federal, state, or local law. This policy of Equal Employment Opportunity applies to all policies and programs relating to recruitment and hiring, promotion, compensation, benefits, discipline, termination, and all other terms and conditions of employment. Any applicant or employee who believes they have been discriminated against by the Company or anyone acting on behalf of the Company must report any concerns to their Human Resources Business Partner, Legal, or Compliance immediately. The Company will not retaliate against any individual because they made a good faith report of discrimination.