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Allied Universal®, North America’s leading security and facility services company, provides rewarding careers that give you a sense of purpose. While working in a dynamic, diverse and inclusive workplace, you will be part of a team that fuels a culture that will reflect in our communities and customers we serve. We offer medical, dental and vision coverage, life insurance, retirement plan, employee assistance programs, company discounts, perks and more for most full-time positions!
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This job posting is for a position in a restaurant owned and operated by an independent franchisee and not McDonald’s USA. This franchisee owns a license to use McDonald’s logos and food products, for example, when running the restaurant. However, this franchisee is a separate company and a separate employer from McDonald’s USA. If you are hired for the job described in this posting, the franchisee will be your employer, not McDonald’s USA. Only the franchisee is responsible for employment matters at the restaurant, including hiring, firing, discipline, supervisions, staffing, and scheduling employees. McDonald’s USA has no control over employment matters at the restaurant. McDonald’s USA will not receive a copy of your employment application and it will have no involvement in any employment decisions, including whether you receive an interview for the job or whether you are hired.
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The Opportunity
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Provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients
The responsibilities include education on access and reimbursement support tools and the participating program, advising healthcare providers (HCP\'s) and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on payor processes and procedures
Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
Managing all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines
Managed through a contact center structure, this role supports outbound and inbound calls to patients, caregivers, specialty pharmacies and healthcare professionals
Performs post benefits investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey
Manages all client inquiries as appropriate, such as specific case statuses
Manages all HCP inquiries, as applicable, pursuant to business rules
All communications with the client\'s field teams will remain compliant and adhere to ways of working protocols
Manages inbound calls as directed by the program-approved FAQ\'s
Triage patients to internal or external resources as appropriate
Provides personalized case management to patients and HCP\'s including outbound communication to HCP\'s and patients to communicate benefits coverage and next steps in obtaining coverage
Leverages electronic tool to identify benefits and payer coverage; completes manual benefit investigations as needed
Identifies and communicates patients\' plan benefit coverage including the need for prior auth, appeal, tier exception, and/or formulary exclusions
Uses electronic resources to obtain benefit coverage outcome and if needed ,outbound call to payers and healthcare providers to follow up on proper submission/or outcome
Compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough efficient management of their records
Adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely
Reporting of Adverse Events/Product Complaint inquiries received in accordance with SOP and good manufacturer practices
Effectively uses internal technology platform to complete claims processing and keep workflows moving
Communicate with key medical practice accounts, sales representatives regarding the status of cases
Provide consultative services where issues arise on how obstacles can be overcome to get patient on paid therapy
Payer benefits experience, reimbursement, or prior authorization experience required
Must be available for an 8-hour shift between 8:00 AM – 8:00 PM
BENEFITS:
Toll Reimbursement Program (valued at $678.60/annually)
Company paid Short-term Disability (STD)
Increased competitive 401(k) company match up to 4%
Affordable Medical, Dental, and Vision benefits
Concierge Medical Clinic free of cost for those enrolled
Wellness discounts of up to $260 per year for participation in wellness program
Annual HSA employer contribution
Company paid and voluntary Life Insurance options
Voluntary Life, AD&D and Long-Term Disability Insurances
Paid Parental Leave of Absence
Wellness and Employee Assistance Programs
PTO benefits, flex days and paid holidays
Employee Referral Program
Ambassador Program
Tuition reimbursement program up to $5,000 per year
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