Sachbearbeiter Krankenkassen (m,w,d) Customer Care Representative Iii

Insmed

Fully remote
Excellent customer service
Respond to customer inquiries
Provide coverage options
Insmed is seeking a fully remote Customer Care Representative who will provide exceptional customer service, assist with reimbursement processes, and ensure effective communication between customers, healthcare providers, and insurance companies. The ideal candidate should have relevant experience in call center environments and familiarity with healthcare reimbursement and durable medical equipment

Job Summary

  • This position is responsible for providing excellent customer service, responding to customer inquiries, providing customers with coverage options, reimbursement processing, order placement, shipping status, warranty and general concerns.
  • The Customer Care Specialist is able to independently follow standardized workflows as defined by the organization.
  • The Customer Care Specialist is not only responsible for ensuring a positive customer interaction, but will also ensure that benefits/coverage, prior authorization and documentation is correctly obtained which will allow Insulet to successfully collect revenue.

Matching Summary

Match Score: 85

Insmed is seeking a fully remote Customer Care Representative who will provide exceptional customer service, assist with reimbursement processes, and ensure effective communication between customers, healthcare providers, and insurance companies. The ideal candidate should have relevant experience in call center environments and familiarity with healthcare reimbursement and durable medical equipment.

Skills & Requirements

Must-have

  • Excellent customer service
  • Respond to customer inquiries
  • Provide coverage options
  • Process reimbursement
  • Place orders
  • Check shipping status
  • Handle warranty concerns
  • Assist with benefits investigation
  • Answer reimbursement questions
  • Communicate with providers
  • Follow standardized workflows
  • Contact center experience
  • Customer service experience
  • Obtain prior authorization
  • Obtain documentation
  • Collect revenue
  • Verify insurance benefits
  • Calculate cost share
  • Enter orders
  • Coordinate product shipment
  • Understand product operation
  • Understand channeling requirements
  • Answer phone inquiries
  • Resolve customer issues
  • Collaborate with other departments
  • Document interactions
  • Maintain HIPAA compliance
  • Calculate cost share amounts
  • Communicate order status
  • Assist with Omnipod orders
  • Manage retail and PBM
  • Verify RX validity

Nice-to-have

  • Durable medical equipment familiarity
  • Pharmacy coverage familiarity
  • Reimbursement experience
  • Healthcare experience
  • Managed care industry knowledge
  • Diabetes knowledge
  • Support customers with diabetes
  • Bilingual skills
  • Salesforce CRM experience
  • Flexibility
  • Diagnostic information gathering
  • Analytical thinking
  • Initiative
  • Self confidence
  • Customer orientation

Key Requirements

  • Call center/customer service experience required
  • Associates degree or equivalent combination of education and experience preferred
  • Relevant call center, reimbursement, healthcare related customer service experience and pharmacy technician license/experience preferred
  • Knowledge of medical device reimbursement from a manufacturer or DME perspective preferred
  • Knowledge of managed care industry is preferred
  • Knowledge of diabetes and experience supporting customers with diabetes is preferred
  • Bilingual skills a plus
  • Experience with Salesforce CRM (preferred)

Work Rights

Not specified

Tailored Resume

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