Case Manager - Customer Service Representative
601 Gateway Blvd South San Francisco, CA 94080
Bayside Solutions is seeking a Case Manager-Customer Service Representative to be part of our client’ s team in South San Francisco. This is an opportunity to work with the largest privately held pharmaceutical corporation in the world and ranks among the world’ s 20 leading pharmaceutical corporations.
Our Client’ s culture is highly collaborative, offers an environment that encourages employees to expand their knowledge in order to make a profound impact on patients’ lives. This could explain why their company has been recognized as one of the “ Top Twenty Employers” in biotechnology and pharmaceuticals by Science Careers.
Our Company Bio: Bayside Solutions was founded in 2001, Bayside was recognized as one of the fastest growing professional staffing companies in Northern California. The numbers tell the story: We have close to a 100% client retention rate, 700% growth in four plus years and over 95% repeat business. Our dedication to building partnership relationships with both our clients and our recruits is the key to our phenomenal success.
You can find additional information on our company website at www.baysidesolutions.com.
- An opportunity to join a patient-focused organization that is driven to develop, manufacture and commercialize medicines to treat life-threatening conditions.
- Work for a company that is local to the bay area and recognized as a leader of innovation.
- Competitive compensation commensurate with experience.
- This position is eligible for medical, vision, dental benefits, paid sick time, and 401K.
Summary of Responsibilities:
- Provides customer focused reimbursement support to patients, pharmacists, physicians and internal sales force.
- Educates, informs, and assists patients and providers to navigate through the reimbursement process for the assigned product.
- Identifies barriers to reimbursement and continually identifies and recommends program efficiencies to the Supervisor to promote high quality of work by Access Solutions/GATCF staff.
- Identifies and facilitates referrals to alternative coverage options and financial assistance programs for patients who are underinsured or require copy assistance.
- Establishes relationships with appropriate stakeholders including internal & external partners.
- May conduct necessary benefits, coverage and payer research/investigations to ensure appropriate resources, compliance with payer appeal policies, practices, timelines.
- Educates, informs and generally assists patients and their families, as well as other related external or internal parties on how to navigate the appeals process.
- This position may require some travel and flexibility in work shift
- Periodic mandatory overtime throughout the year is required. This may include, but is not limited to, high referral season, new product or system launches, enrollment renewals, new line extensions, or any unexpected surge in volume or backlog situations.
- Workdays are M-F, but may include weekends as needed.
Summary of Qualifications:
- High school diploma or AA with five years of working experience is acceptable.
- Bachelor’ s degree is highly preferred with one to two years of experience.
- A minimum of 1-2 years of data entry is preferred.
- Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules).
- Demonstrates effective problem-solving skills and provides excellent customer service.
- Excellent investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format.
- Ability to work collaboratively in a team structure and responsibly delegates next steps to appropriate team members.
- Must be able to work in a fast paced environment, multitask, and maintain attention to detail.
- Must have a reliable mode of transportation.
- Must be able to work effectively under pressure and prioritize tasks.
- Must be able to follow written Standard Operating Procedure.
- Recommended experience with Mac operating systems.