Customer Care Associate

Job Description

Job Description

Job Summary:

Under the general supervision of the Reimbursement Supervisor, the Customer Care Associate (Reimbursement Intake) supports a variety of reimbursement and customer service functions within a specialty pharmacy environment. This role is an excellent opportunity for individuals beginning their careers, who are eager to learn healthcare reimbursement, insurance processes, and patient support services. The Customer Care Associate assists with manufacturer services ("HUB") intake, pharmacy clearance activities, claim submission, payment posting, patient and provider communications, and other reimbursement-related functions. Comprehensive training will be provided to help candidates develop the knowledge and skills needed to succeed in the role. The below is intended to describe the general content of and requirements for the performance of this job and is not to be construed as an exhaustive statement of essential functions, responsibilities, or requirements.

Primary Duties and Responsibilities

1. Handle inbound and outbound calls with patients, providers, insurance companies, and other healthcare partners.
2. Accurately enter and process inbound documentation, including referrals, prescriptions, reimbursement documents, and HUB-related materials in a timely manner.
3. Maintain patient confidentiality by following HIPAA guidelines and all company policies and procedures.
4. Document and escalate adverse events in accordance with company training and procedures.
5. Verify insurance benefits and coverage information for patient prescriptions.
6. Communicate insurance coverage and benefit information clearly and professionally to patients.
7. Assist with obtaining prior authorizations and appeals for patient prescriptions.
8. Learn reimbursement methodologies, payer requirements, and company reimbursement guidelines.
9. Follow company policies regarding co-pay assistance, patient assistance programs, and other financial support resources.
10. Adhere to manufacturer program requirements during patient onboarding and help connect patients with available assistance programs.
11. Regular and reliable attendance is expected.
12. Other work-related duties as assigned by supervisor/manager.

Minimum Knowledge, Abilities, and Skills Required

1. High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
2. Bilingual candidates are strongly encouraged to apply; fluency in Spanish is a plus.
3. Previous customer service, administrative, healthcare, call center, pharmacy, insurance, or reimbursement experience is helpful but not required.
4. Recent college graduates and entry-level candidates are encouraged to apply.
5. Strong interpersonal skills with a passion for helping others and providing excellent customer service.
6. Highly organized, detail-oriented, and able to manage multiple priorities.
7. Basic proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
8. Demonstrated reliability, professionalism, and a strong work ethic.
9. Strong verbal and written communication skills.
10. Ability to learn new systems, processes, and healthcare reimbursement concepts.
11. Required years of experience
12. Professional certifications and/or licensures
13. Other related minimum expectations

This description is intended to be only a general outline of major activities. It is expected that the employee performs these and any other activities which may be assigned, or which may occur in the normal course of work. This description is not a contract or guarantee of employment. AnovoRx is an Equal Opportunity Employer.