Job Description: Customer Connections Specialist (JB27)
The Customer Connections Specialist (CCS) is responsible for working in conjunction with the Sales Representatives to promote the organization and increase its customer base as well as working to maintain current business relationships with targeted accounts.
The CSS is knowledgeable of all products and services of OptiMed Health Partners, including the Specialty Pharmacy and Infusion lines of business. His/her primary responsibility is to promote the organization’s products and/or services to prescribers, nurses, pharmaceutical manufacturers, third party administrators, insurance brokers, health plans, and PBMs while positioning him/herself as the core point of contact.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The essential duties and responsibilities of the CCS include, but are not limited to:
a. Maintain a current and thorough knowledge of all OptiMed’s services and lines of business.
b. Identify, build, and maintain relationships with prescriber’s offices that deal with complex chronic diseases including, but not limited to, immune disorders, multiple sclerosis, psoriasis, rheumatoid arthritis, inflammatory bowel disease, hepatitis C, HIV, and cystic fibrosis.
c. Act as the internal point of contact for sales representatives, pharmaceutical partners, and other sales inquiries.
d. Use effective verbal and written communication via phone, fax, and email to consistently move customers toward a commitment to using OptiMed as their Specialty Pharmacy/Infusion Provider/Health Partner of choice.
e. Review reports of new referrals and make New Prescriber Introduction Calls to provider offices.
f. Answer inbound calls and initiate outbound calls to customers for sales solicitation and/or follow up.
g. Work closely with Management and Sales Representatives to determine best plan of action for top accounts in assigned geographies.
h. Communicate with Patient Care Coordinator (PCC) team on potential issues/concerns to investigate or resolve.
i. Inform PCC team of any necessary or critical notes, preferences, or special requests relayed from provider accounts.
j. Assist with marketing phone, fax, and direct mailing campaigns.
k. Plan, implement, and attend meetings sponsored by clients or special interest groups to promote products and services as determined by the Directors, CEO, and/or VP of Industry Relations & Business Development.
l. Travel to customer locations, conferences, trade shows, seminars, etc. as needed.
m. Uphold the highest ethical standards; comply with all OptiMed Health Partners policies and procedures as well as governmental regulations, third party contracts, and accreditation standards.
n. Thoroughly document activities and follow up.
The CCS is a full-time position. 2+ years of customer service preferred. Business-related BA preferred, but not required. Must have excellent, clear verbal communication skills and the ability to build relationships via telecommunication methods.
The CCS thrives in a fast-paced work environment. Must be able to sit for prolonged periods of time at a desk and perform work on a computer in an office environment. Potential for minimal local travel, overnight travel, and weekend and/or evening work, as necessary. Minimal heavy lifting may be required at times, as necessary to move or transport marketing materials.
Job Description: Medical Biller & Infusion Coordinator (JB17)
The Medical Biller & Infusion Coordinator is responsible for working directly with patients, payers, prescribers and other clinical and administrative staff to ensure the proper billing and reimbursement of services performed. The associate will also collaborate on care coordination for infusion patients.
The Medical Biller & Infusion Coordinator is knowledgeable of payer requirements, pharmacy and medical benefits, prior approval processes, medical necessity requirements, claims submission, account monitoring and current legislation pertaining to patient rights and billing standards. Regular review and consideration must be taken to stay current with HCPCS, diagnostic coding and modifiers. The individual will need to work with clinical staff members and other individuals as it relates to care coordination for infusion services. S/he will assist in developing and maintaining current billing processes pertaining to both patients and payers. This individual will also work regularly with entities such as the clearing house for accounts receivable.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The duties and responsibilities of the Medical Biller & Infusion Coordinator include, but are not limited to:
- Conduct a thorough investigation of a patient’s benefits
- Satisfy any prior approval processes
- Patient education on benefits, approvals and any cost shares expected
- Collection of funds
- Conduct coding for billable services
- Submission of claims
- Claims monitoring
- Collaborating with the clearing house on claim edits
- Claims and patient payment posting
- Working any denials or claims’ request such as appeals, resubmissions or additional documentation requests
- Establishing relationships with third parties such as vendors and payers
- Coordinating care with all parties involved
- Front desk/administration assistance
The Medical Biller & Infusion Coordinator does not hold any direct supervisory roles. The Medical Biller & Infusion Coordinator reports to the Corporate Relations and Contracting Manager.
College degree and at least two years’ medical coding, billing and reconciliation experience in the healthcare industry is required. Related experience in collections, finance, patient care and communications, or similar qualifications are highly desirable. Knowledge with EMR systems, healthcare compliance and related legislation is a must. The Medical Biller & Infusion Coordinator needs to have outstanding verbal and written communication skills as they will be a key contact point for the company. Must have ability to work effectively within all levels of the organization, from executives to individual contributors. Strong project management and cross-group collaboration skills with a demonstrated ability to plan and drive results and achieve deadlines (especially pertaining to diligently working within Timely Filing Constraints) is key. Individuals should be able to maintain a strict level of confidentiality, demonstrate outstanding judgement, and be able to manage multiple tasks/projects simultaneously.
The Medical Biller & Infusion Coordinator thrives in a faced-paced work environment. Must be able to sit for prolonged periods of time at a desk and perform work on a computer in an office environment. Minimal lifting as required for office supplies and equipment.