ClaimSecure Hiring for Customer Service Advisor at Mississauga, ON Full Time

Reporting to the Clinical Services Manager, the Clinical Services Specialist is responsible for day-to-day operations supporting the Clinical Services team relating to Coverage Navigation Services and respond to client and member inquiries.

Principal Responsibilities:

• Receive, handle and evaluate coverage navigation applications
• Manage all aspects required to obtain prescription drug coverage for patients
• Maintain communication between internal and external stakeholders
• Coordinate cases with public & private payers, physicians offices & pharmacies, and any relevant health care providers in order to maximize reimbursement options
• Coordinate all documents and related paperwork to private & public payers
• Liaise with internal stakeholders for report generation
• Respond to client inquiries related to coverage navigation cases and provide status updates
• Act as the primary resource of contact for members, internal partners and external clients
• Maintain high standards of professional practice by adhering to the ethics of the profession and keeping abreast of the latest professional advances
• Monitor Coverage navigation cases and ensure goals are met on daily, monthly and quarterly basis
• Ensure continuity of care for cases is maintained and that any changes in application progress are clearly identified and transitioned accordingly
• Provide written and verbal communication to members, clients, and internal partners
• Identify process gaps, develop strategies to overcome operational challenges, and implement new processes as required
• Assume responsibility for personal and professional development
• Acquire and maintain extensive knowledge of private and provincial funding

Knowledge, skills and experience:

• Post-secondary education is Mandatory;
• Ability to organize, coordinate and prioritize own work;
• Demonstrated strong ability to effectively communicate (verbal/written);
• Previous experience working in Pharmacy setting is required ( 2-3 years);
• Previous experience in pharmacy benefit management, insurance, and/or reimbursement is preferred
• Knowledge and/or previous exposure to provincial and private drug plans, medication access and reimbursement programs;
• Proven and demonstrated interpersonal and leadership skills;
• Demonstrated capacity to liaise in a constructive and collaborative fashion with a variety of healthcare providers, clients and staff at various organizational levels;
• Excellent analytical and problem solving skills;
• Solid presentation skills;
• Working knowledge of MS Office Applications is a MUST – Word, Excel, PowerPoint;
• Demonstrated critical thinking, problem solving skills and attention to detail;
• Demonstrated commitment to collaborative practice and lifelong learning;
• Bilingualism (English/French) is an asset

Job Type: Permanent

Benefits:

• Company events
• Dental care
• Disability insurance
• Employee assistance program
• Extended health care
• Flexible schedule
• Life insurance
• Profit sharing
• Vision care
• Wellness program
• Work from home

Schedule:

• 8 hour shift
• Monday to Friday
• No weekends

Experience:

• customer service: 1 year (preferred)
• Retail Pharmacy: 2 years (preferred)

Language:

• Bilingual (English/French) (preferred)

Licence/Certification:

• Pharmacy Technician Diploma (preferred)

Work remotely:

• Yes