About the Company

EMD Serono, Inc., an affiliate of Merck KGaA, Darmstadt, Germany, is a leader in the US biopharmaceutical arena, integrating cutting-edge science with unparalleled patient support systems to improve people's lives. The company has strong market positions in neurodegenerative diseases, MS and endocrinology. EMD Serono is also a leader in fertility treatments. With a clear focus on the patient and a leadership presence in the biopharmaceutical industry, EMD Serono's US footprint continues to grow, with more than 1000 employees around the country and fully integrated commercial, clinical and research operations in the company's home state of Massachusetts.

The schedule for this position is Tuesday thru Saturday, 8:45am to 5:15pm

Description

The Medical Reimbursement Specialist (MRS) will play an integral role within EMD Serono's Patient Support Call Center, MS LifeLines, (MSLL) as part of the overall Patient Marketing function within the Neurology Department. This individual will be directly responsible for providing assistance and support with reimbursement for patients, family members, caregivers, nurses, physicians, and or pharmacists. All cases will be handled with personalized attention and the utmost of confidentiality. In this role the individual will address reimbursement related inquiries, assess patients' coverage options, provide eligibility and benefit verification, secure insurance authorizations, advocate for maximum reimbursement coverage on a case-by-case basis from third party payers, and provide support on insurance denials.

Key Tasks & Responsibilities

• Consistently provide a high level of customer service to both internal (sales force, managed care, nurses) and external customers (patients, physicians, pharmacies, insurers).
• Maintain accountability for day-to-day patient reimbursement activities, workload and overall workflow.
• Responsible for specific geographic territories. Manage tasks and activities assigned by territory to ensure a high level of patient and physician satisfaction
• Provide feedback from customers on services offered and share unique situations/issues to ensure common response from patient support services.
• Work on patient's behalf to identify and assess reimbursement coverage options for those with insurance and to coordinate and/or investigate financial options for those without insurance.
• Work with physician offices and/or pharmacies to facilitate the process of obtaining prior authorization from third party payers in order to maximize patients' access to treatment.
• Monitor, follow-up with and record all insurance re-authorizations required by payers to help ensure compliance and continuity of treatment.
• Help support the appeal process to overturn insurance denials and/or benefit exclusions when needed.
• Maintain database for recording, managing, and monitoring patient activities for those requiring reimbursement support.
• Provide and analyze data for reporting and trending.
• Serve as liaison and resource for addressing general product and/or device related questions.
• Maintain a collaborative approach with members of call center team.
• Demonstrate the utmost sensitivity and confidentiality to information while maintaining a high level of professionalism.
• Assume additional projects on an as needed basis.
• Perform the duties and responsibilities of Customer Support Specialist as necessary.
• Continued education is required. Technical expertise in assigned therapeutic area may be necessary and updates in current therapy will be required. For example in Multiple Sclerosis it is important to remain current in new therapies and industry advancements.
• Attendance of certain association meetings during the year may be required to receive updated information or competitive review. Education & Languages
• College Degree required (Associates/ Bachelors) or equivalent
• Bilingual capability is a plus.