Description

eBlu Solutions is a unique software solution that streamlines benefit verifications for high-cost infusions in medical practices.

The Senior Pharmaceutical Product Research Specialist will be a part of a dynamic team that has the opportunity to support patient access to care through the support of healthcare practices, pharmaceutical company representatives, and healthcare service companies for specialty prescription drugs who can encounter reimbursement and billing challenges.

The Senior Pharmaceutical Product Research Specialist will use investigative skills to navigate various payers, insurance, and employer plan coverages to provide the necessary benefits and support that connect a patient to receive treatment.

• Provides the highest level of customer service when representing eBlu Solutions (This applies to internal and external partners).
• Exhibit critical thinking and investigative behaviors throughout the workday.
• Conduct full medical and pharmacy benefit investigations.
• Utilization of all resources and tools i.e., OneNote, Portals, Google, etc.
• Senior Pharmaceutical Product Research Specialist will have a working knowledge of automated warehouse operating systems.
• Exhibits the ability to understand and interpret EOBs & SOBs (i.e., interpreting claims).
• Researches and maintains payer medical policies and prior authorization forms.
• Exhibits the ability to pivot between workflows to support healthcare practices and team members throughout the day.
• Pharmaceutical Product Research Specialist will need the ability to consistently meet deadlines.
• Provides prompt communication to the Supervisor to ensure updated information is captured, retained, and updated promptly.
• Strong attention to detail, analytical skills, and decision-making skills.

Requirements

• Three years of experience in a health plan, facility, healthcare provider office, or pharmaceutical industry
• Understanding of health plan medical policies and prior authorization criteria
• Reimbursement experience (i.e. benefit investigation, prior authorization, pre-certification, letters of medical necessity)
• General knowledge of patient assistance programs and database elements and functionality; operational policies and processes
• Professional Communication (written/verbal)
• Precise, concise, and can articulate information succinctly
• Attention to detail
• Accuracy
• Organized and self-led
• Time Management Skills
• Strong prioritization skills
• Mastery of Payer Portals
• Proficient in making benefits calls with guided call scripts
• Understanding of Buy & Bill
• Proficient technical skillset
• Robust research and investigative skillset
• Ability to retain information to produce high-performance results

Behaviors:

• Helpful to peers - approachable, collaborative, supportive (training, feedback, & assisting)
• Create and maintain a constructive and positive working environment
• Critical thinker- the ability to question historical data with current data and reps to gather accurate information
• Drive and Determination
• Enhanced Investigative nature
• Reliable
• Meets Deadline Expectations
• Ability to accept constructive feedback
• Ability to recognize goals, measurements of success, and deliver results at the pace of the organization, assignment, or workload required