Customer Service/Insurance Advocate


Customer Service/Insurance Advocate

Job Description

  • Process all aspects of the order process by verifying insurance benefits/coverage to determine eligibility and calculate cost share amounts for existing and new customers.
  • Requesting and collecting updated documentation, prior authorizations, order entry and coordinating shipment of product to customers.
  • Must maintain a thorough understanding of products offered by the client.
  • Understand the clients channeling and processing requirements for all covered products, which is based on medical policy and payer guidelines.
  • Work as part of the larger support team, collaborating with other departments to ensure proactive, superior front-line customer support.
  • Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.
  • Provide frequent feedback and suggestions to support an environment of continuous process improvement.
  • Serving as a department expert on all client insurance contracts, channeling and processing requirements for all covered products.
  • Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.
  • Submission of all prior authorization requests for approval and payment of the clients products at time of claim processing.
  • Calculate and document cost share amounts for potential customers.
  • Collaborate with other commercial teams such as Case Management, Sales and Billing, to ensure proactive communication of potential customer’s order status.
  • Using their advanced knowledge and skill set, this position could be called upon to complete a wide range of task within the Reimbursement team.
  • Perform other duties as assigned.