JOB SUMMARY: Under the direction of the Senior Manager of Specialty Operations, the Lead Specialty Copay Coordinator will execute operational processes for access and application of copay assistance for members, in collaboration with internal and external partners. This role will assist in implementing quality controls in addition to modeling and facilitating operational vigor amongst the team. Lead Specialty Copay Coordinator will support in the peer mentoring, training and credentialing activities within the department. Lead Specialty Copay Coordinator will possess attention to detail, high productivity, have the ability to multi-task and exceed production targets while ensuring quality outputs.

WORK SCHEDULE: Monday - Friday 11:30 AM - 8:00 PM

Duties and Responsibilities:

• Perform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirements.
• Assist in facilitating new hire and refresher training for specialty technicians and coordinators.
• Perform credentialing to technicians and coordinators, ensuring they meet key criteria to begin productivity across various tasks and systems.
• Develop and administer skill enhancement sessions for peers.
• Provide mentoring to peers as requested by senior management.
• Generate internal data reporting within data analytics system to assist with daily activities.
• Timely and accurate input of copay assistance into the system and evaluating system to ensure accuracy of claims being paid at the designated override amount.
• Facilitate fill and transfer process for specialty medications.
• Handle inbound calls from patients, prescriber offices, and pharmacies.
• Perform outreach to members to facilitate copay assistance enrollment process.
• Facilitate outbound calls to patients, physician offices or pharmacies as needed to ensure prescriptions are submitted and to coordinate accurate processing of copay assistance.
• Utilize internal and external data systems to process copay cards.
• Document case activity, communications and correspondence in data systems, ensuring thoroughness and accuracy of entries.
• Maintain accurate patient demographic, status, and copay assistance information in data systems.
• Troubleshoot claim rejections, claim reversals, and allocation deficiencies.
• Resolve escalations that may have resulted from incorrect or incomplete information, therapy changes and pharmacy errors and communicate root cause/resolution to respective team members.
• Communicate with internal and external partners via email correspondence to address copay related inquiries.
• Provide benefit coverage details for inbound benefit investigation calls received from external parties.
• Perform quality control and auditing activities.
• Ability to perform all duties of specialty coordinator and specialty technician.
• Any other duties required to maintain a productive environment.
• Other duties as assigned.

Qualifications:

• High school diploma or equivalent.
• One year of performing duties associated with Specialty Technician or Specialty Coordinator role supporting manufacturer copay assistance programs.
• In depth understanding of affordability and patient assistance programs and operations.
• Prior experience in the pharmaceutical, healthcare or managed care industry required.
• Knowledge of and previous experience in claims processing and adjudication.
• Basic mathematic and computational skills required.
• Proficient Computer skills in a Windows environment are required.
• Solid knowledge and working experience with various software packages to include Microsoft Word, Outlook and Excel is required.
• Proficient in working within the BeneCard PBF and BCF systems, with at least 1 year experience working within both systems.
• Proficient analytical skills with strong attention to detail.
• Must have experience in Customer service.
• Must be able to communicate with internal partners in a professional manner; orally and written.
• Must be able to work in a team environment, prioritize and organize multiple tasks, and meet multiple deadlines to complete essential tasks.
• The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies.

Featured Benefits

• Competitive salary
  • Potential to earn $1,000 sign-on bonus
• Vacation and Sick/Personal Time
• Medical Insurance
• Hearing Program Discount
• Short- & Long-Term Disability Insurance
• Life Insurance
• Flexible Spending Account
• 401(k)
• Employee Referral Program
• Employee Recognition
• Tuition Reimbursement
• Professional Development Training

About Benecard Services our affiliated companies:

Benecard Services, LLC

Benecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey.

Website: http://www.benecard.com

BeneCard PBF

BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care. Headquartered in Bonita Springs, Florida.

Website: http://benecardpbf.com

National Vision Administrators

For over 40 years, National Vision Administrators (NVA) has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care. We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members. Headquartered in Clifton, New Jersey.

Website: http://www.e-nva.com

We are an Equal Opportunity employer.