FIELD SPECIALIST LIAISON
Location: Rockville Maryland
Description: A-Line Staffing Solutions. is currently seeking to employ FIELD SPECIALIST LIAISON right now, this vacancy will be placed in Maryland. More details about this vacancy opportunity please give attention to these descriptions. A-Line Staffing is currently recruiting for a Filed Specialist Liaison for a fast growing pharmaceutical company in Rockville, MD. If interested in please see below and co! ntact: Jessica DiCicco877-782-3334 X227jdicicco@alinestaffing.com *Conduct comprehensive insurance verifications for complex therapy for the full range of insurance plans, public and private. Solve obstacles to coverage confirmations by: *Define which specialty pharmacy provider should dispense on particular cases taking into consideration contractual and other defined operational rules. Uses good judgment to determine when it is appropriate to aggressively pursue Assignment of Benefits (AOB) as requested by the treating physician.*Obtain authorizations for full scope of billable therapy, based on the specific clinical use for that patient; confirm authorizations in writing. Define claim submission requirements including method of submission (electronic/paper), format, codes, wording, etc. unless otherwise defined by payer. Facilitate agreements with insurance case managers. Define and obtain any medical information required by an insurer.*Explain medical need to insurer fo! r specific therapy as ordered by physicians and supported by m! edical documentation and ability to explain/provide resources about the therapy itself. Must be able to summarize the differences between a clinically unique therapy and other drugs used to treat the diagnoses and provide insight to the payer as to why this therapy is typically prescribed.*Communicate updates to management relative to negative policy coverage from insurers*Maintain and record accurate detailed records.*Re-verify insurance coverage and pursue recertification as necessary.*Interact with RNs, Pharmacists, manufacturer sales reps or health care providers as needed to meet the requirement.*Handle escalated calls and escalated case issues.*Discuss and refer patients to manufacturer patient assistance programs and/or other manufacturer support programs.*Negotiate with Specialty Pharmacies to provide in-network benefits to patients while accepting out-of-network rates from the payer.*Handle all communications with the field force for multiple therapies.*Research an! d resolve field inquiries ranging from general process questions to escalated issues.*Troubleshoot and review patient status in regards to questions coming in from field personnel.*Discuss and clarify Standard Operating Procedures with the Nurse Educators as needed.*Receive and log all incoming Issue Communication Forms.*Minimal overnight travel required/ possible.*Other duties as assigned. QualificationsDemonstrated excellent customer service approach in verbal and written communications.Demonstrated ability to work as a team member with a customer satisfaction focus.Demonstrated effective problem solving ability.Demonstrated ability and initiative to work independently.Strong interpersonal, communication, time management, organizational and customer relations skills. EducationDegree from an accredited college/university or equivalent experience Experience3+ years experience and knowledge with public/private health care and pharmacy reimbursement systems or 3+ years experi! ence in customer service, billing, collections and/or telephonic servic! e delivery.jdicicco@alinestaffing.com
Skills/keywords: Insurance Verification, Reimbursement, prior authorization, Re-verification's,
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to A-Line Staffing Solutions..
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This vacancy starts available on: Thu, 29 Aug 2013 09:43:09 GMT