Customer Care Representative III

Role Overview

• Process all aspects of the order process by verifying insurance benefits to determine eligibility and cost share amounts , reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.
• Serving as a department expert on escalation calls/tasks, Insulet insurance contracts, channeling and processing requirements for all covered products.
• Requesting and collecting updated documentation, order entry and coordinating shipment of product to customers.
• Must maintain a thorough understanding of products offered by Insulet with the ability to explain to potential or existing customers the basic operation and use.
• Answering phone inquiries and providing support and direction to customers and resolving customer service issues in a timely and empathetic manner.
• Submission of all prior authorization requests for approval and payment of Insulet products at time of claim processing.
• Calculate and document cost share amounts for potential customers.
• Collaborate with other commercial teams such as Case Management, OmniPod Sales and Billing, to ensure proactive communication of potential customer’s order status.
• 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.
• Using their advanced knowledge and skill set, this position could be called upon to complete a wide range of task within the Reimbursement team.
• Performs other duties as assigned.

Requirements

• Associates/Bachelor’s Degree and/or equivalent combination of education and experience preferred not essential
• Relevant experience in a professional working environment, preferably with extensive phone coverage and medical device or health care oriented.
• Individual health plan insurance knowledge and understanding of the managed care industry is required.
• Knowledge of diabetes and experience supporting patients with diabetes is preferred.
• Experience with Salesforce CRM (preferred).

Benefits

• Health insurance
• 401(k)
• Paid time off
• Flexible working arrangements
• Professional development opportunities