Resolution Specialist

About the Organization The Assistance Fund (TAF) is an independent charitable patient assistance organization that helps patients and families facing high medical out‑of‑pocket costs by providing financial assistance for their copayments, coinsurance, deductibles and other health‑related expenses. TAF currently manages more than 80 disease programs, each of which covers the FDA‑approved treatment for a specific disease. Our vision is to see the day when no person goes without treatment because of an inability to pay. Equal Employment Opportunity Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. Job Description The Resolution Specialist (RS) responds to and manages complaints and escalations from patients, providers, sites of care, pharmacies, and others directing to The Assistance Fund (TAF). The RS is responsible for managing the resolution of escalation cases and providing feedback to senior leadership regarding patient experience and service issues. The RS communicates with patients and callers over the phone and via email using excellent communication skills, collaborates with internal teams to understand patient needs, and diffuses situations between patients and employees. As a Resolution Subject Matter Expert, the RS ensures the full resolution is completed, including processing reimbursement claims and confirming payment receipt. The RS also reviews reporting and analyzes data to provide insights for escalation reduction, and provides back‑up support to the Provider Specialist and assists with override processing as required. Responsibilities Handles, de‑escalates, and resolves complaints posted on social media, sent via email, and received in the mail to executive communications sent to leadership at TAF. Handles, de‑escalates, and resolves complaints received through phone calls and live chats directly sent through TAF Contact Center. Responds to complaints utilizing excellent verbal and written communication skills. Conducts investigations to determine the root cause, defines areas of opportunity for improvement, and documents and reports outcomes. Participates in the development and implementation of new resolution management policies and procedures to ensure effectiveness. Works with Operations Management to create reports for escalation case activity to share with supervisors and leadership. Maintains Patient Advocate II skills and knowledge; attends all training for Patient Advocates. Processes reimbursement claims as required to provide complete resolution of cases, fully trained as a Claims Specialist. Utilizes problem‑solving skills to resolve disputes, address complaints, and identify the source of patient experience issues. Has excellent patient experience skills and can diffuse escalations. Works effectively in a fast‑paced environment and manages demanding situations. Position Requirements High School diploma or GED. Claims processing experience at The Assistance Fund is highly preferred. At least two years of experience in a patient or customer service role. Experience in a call center or customer service department. Healthcare experience is preferred but not required. Effective written and interpersonal communication skills. Strong attention to detail and a high degree of accuracy. Ability to think creatively and apply knowledge of the changing healthcare environment. Ability to multi‑task. Physical Demands The work requires the incumbent to remain at a desk most of the time. Some travel may be required to represent the company at meetings, conferences, and seminars. Tight deadlines must be met with limited staff to support projects. Work Environment The work environment is an office setting that is adequately lighted, temperature‑controlled, and ventilated. Other Duties Note: this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change at any time with or without notice. This position is currently accepting applications. #J-18808-Ljbffr