Care Manager Patient Call Center - Home-based

Care Manager

Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status.

Responsibilities will vary by program and its lifecycle. Care Manager's may be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care Managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position.

Job Responsibilities:

• Perform outbound calls to obtain appropriate information and document accurately.
• Responsible for answering in-bound calls and assisting customers with pharmacy related services.
• Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service.
• Contact insurance companies for benefit investigation and coverage eligibility.
• Provide prior authorizations and appeals support.
• Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs.
• Update job knowledge by participating in educational opportunities and training activities. Work efficiently both individually and within a team to accomplish required tasks.
• Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's.
• Report ADE's according to program policy and guidelines Adhere to all HIPAA guidelines May assist with onboarding new employees.

Schedule:

• Must be available for an 8 hour shift between 8am-8pm EST

Required Qualifications:

• High School Diploma or equivalent
• Minimum one year experience in medical billing, reimbursement, insurance verification, or similar related medical office experience.
• Previous data entry experience (minimum three months) and ability to type 30wpm+
• Able to demonstrate high attention to detail in work.
• Must be computer savvy, to include navigating multiple computer tabs, monitors, and applications.
• Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc.) and soft phone systems (WebEx, Mitel, Shoretel, etc.).
• Exceptional communication skills, both written and verbal.
• Able to work in a virtual team environment by being available and responsive during working hours.
• Excellent follow through This is a remote position.
• Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines.
• Workspace must include internet plug-in accessibility. Wi-fi connectivity is not permitted.
• Must reside in country where the job is posted.

Preferred Qualifications:

• Some College.
• Bilingual Spanish - English
• Previous experience in Patient Support Services (Hub).
• Previous Customer Service experience in the healthcare field.

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law.

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $22.00 - $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.