About the job
The Customer Service Specialist for Health Care serves as the primary liaison for Health Care Providers (HCPs) and patients, addressing intricate patient access challenges. In this role, you will become a subject matter expert in insurance processes, prior authorizations, exceptional customer service, and alternative funding strategies.
Your responsibilities will include providing clear and accurate information regarding patients' medical and pharmacy benefits, financial assistance, and access inquiries. You will enhance the efficiency of the wider access team by managing and disseminating insurance intelligence.
Responsibilities include:
- Delivering top-notch customer service for inbound and outbound calls to ensure first-call resolution.
- Offering insights on insurance coverage, verification details, prior authorization statuses, and alternative funding options for both existing and newly launched products.
- Providing healthcare offices with updated plan forms, portals, and websites for prior authorizations and appeals.
- Clearly communicating and educating customers on the outcomes of their inquiries.
- Investigating and resolving complex issues for patients facing escalated challenges such as access difficulties or savings card issues.
- Conducting benefit investigations and liaising with HCPs, patients, or pharmacies as necessary.
- Adapting quickly to business process changes related to all drugs and channels.
- Documenting information accurately in the required systems and communicating insurance details effectively via phone, electronic methods, and fax, adhering to established policies.
- Identifying potential Adverse Event situations for reporting to Pharmacovigilance, ensuring compliance with FDA regulations.
- Supporting changing business priorities by remaining flexible in task execution to benefit patients and the services provided.
- Collaborating cross-functionally to identify and implement process improvements.
- Liaising with healthcare providers, insurance companies, AbbVie Patient Access Support representatives, filling pharmacies, and patients to effectively administer Patient Support Service programs.
- Educating stakeholders on access processes tailored to their patients' insurance plans.
