Harmony Care Specialist

San Jose, California | Contract

Post Date: 10/23/2017 Job ID: 3482 Industry: Administration

As a Harmony Care Specialist (HCS) you will be responsible for verifying patient specific benefits, for the Harmony Prenatal test.   This role will eventually align with a specific field sales rep(s) or field sales team. The HCS will support and service patients via phone.

 

Primary Purpose: 
 

The Harmony Care Specialist will provide professional customer service to individuals inquiring about Harmony. Provide product information and provide patients with benefit verification for the Harmony Prenatal Test. Follow up on issues which hinder order “ real-time” benefit verification. The HCS will advise patients on billing next steps such as; EOB’ s, claims, invoices and medical necessity requirements. The ability to route patients to correct departments for other needs, related to billing issues. 

 

Responsibilities:
  • Ability to provide an exceptional customer service experience to the customer.
  • Receive inbound calls and advice customers regarding, patient specific insurance plan types and medical necessity requirements.
  • Assist with prior authorization when needed
  • Provide patient specific billing details; co-insurance and deductible information
  • Communicate payer specific in-network and out of network details
  • Explain and provide guidance for the patient assistance program and patient protection program
  • Update patient demographic information
  • Route patients to appropriate internal and external departments as needed
  •   Must demonstrate the ability to multitask and focused attention to detail required. Detailed oriented-will be documenting calls for audits, highly regulated environment.
  • Strong verbal and written communication, listening and documentation skills required.
  • HCS will interface with external and internal customers on routine issues and inquiries
  • HCS was be respond in a timely manner to customer inquiries (internal and external)
  • Ability research information in order to follow up on patient inquiries
  • HCS may be required to participate in special projects
  • High level of energy and a desire to thrive in a growing, complex, fast-paced organization; ability to handle multiple tasks under pressure
  • Strong work ethic, including the ability to work independently, but also knows how to have fun while doing it
  • Ability to professionally receive constructive criticism and feedback/coaching from our QA coaches and supervisory staff.



 

Required Qualifications:

  • Bachelor’s Degree or equivalent experience
  • 3+ years relevant work experience
  • Problem solving skills
  • Ability to work in a regulated environment
  • Ability to understand technical market issues and factors
  • Proficiency with MS Outlook, Word, Keyboard Proficient, Internet, dual screens and ability to learn and adapt to other software’s required.
  • Accurate and efficient typing skills minimum 40 wpm required.
  • Strong oral and written communication skills with the ability to listen mindfully, identify gaps and ask appropriate questions.
  • Proven ability to meet KPIs (Key Performance Indicators) metrics required.
  • Contact or Call Center preferred.
  • Customer service experience via phone preferred.
  • All other duties as assigned.

 


Working Environment:

  • This position operates in a professional regulatory contact center.
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