[19 / 10 / 2025] Program Specialist

Role & responsibilities

Quickly and efficiently respond to incoming calls and faxes, identify how best to assist.

• Conduct outbound calls of insurance verifications to understand if patients prescribed therapy is eligible for coverage. Document results in appropriate tracking system.
• Document calls in appropriate tracking systems, and handle / escalate calls per established procedures.
• Process patient applications and follow the program's specifications to determine their eligibility. Document results in appropriate tracking system and manage follow-ups as appropriate. Place follow-up calls and respond to enquiries from patients and / or healthcare providers as necessary.
• Maintain a professional, calm and friendly demeanor. Express thoughts and instructions clearly in both verbal and written communication; i.e. uses grammatically correct and concise language.
• Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate.
• Be familiar with the market place and the insurance options available for patients. Educate patients on the available options as appropriate.
• Strict adherence to follow the process SOPs

Preferred candidate profile

Proficient in English, verbal and written