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Full-Time

Inbound Patient Advocate

Posted on 10/1/2024

SmithRx

SmithRx

201-500 employees

Pharmacy benefit management with transparent pricing

Enterprise Software
Healthcare

Compensation Overview

$23Hourly

+ Promotion Opportunity

Junior

Plano, TX, USA

Candidates must be locally based; potential to work from home four days per week after 60 days of onsite onboarding.

Category
Customer Support
Customer Success & Support
Required Skills
Communications
Salesforce
Requirements
  • Candidates must be locally based. Potential to work from home four days per week based on performance, after 60 days of onsite onboarding
  • Requires 100% attendance during training period
  • High school diploma, GED, or equivalent
  • Extensive experience in customer support roles with at least 2+ years of experience in healthcare call center environments handling inbound call is required. Outbound call experience is preferred
  • Proficiency in Windows, MS Office, G-Suite required. Salesforce experience preferred.
  • Knowledge and understanding of pharmacy benefits manager (PBM) systems and processes is preferred
  • Knowledge of health insurance plans and medication reimbursement processes is preferred
  • Understanding of drug savings programs and patient assistance programs is preferred
  • Exceptional verbal and written communication skills.
  • Demonstrated professionalism, active listening, and empathetic conversational skills.
  • Ability to multitask, prioritize effectively, and manage time efficiently.
  • Ability to quickly identify issues, determine the best course of action, and resourcefully find solutions to complex problems.
  • Ability to learn and adapt to new technologies and processes quickly.
  • Critical thinking skills with the capability to navigate through ambiguity and adapt to change.
Responsibilities
  • Educate patient members about their pharmacy benefits and help them source medications they need through various programs.
  • Provide support to/ assist members, providers and pharmacies via inbound phone calls, email, and other appropriate communication channels
  • Handle inbound calls pertaining to enrollment in drug savings programs and resolve their inquiries.
  • This role’s success metrics include providing one-call resolution to members, providers, and pharmacies
  • This role will gather any missing necessary information to successfully resolve the case, with emphasis on a one-call resolution approach.
  • This role requires good understanding of all Patient Access savings programs
  • Coordinate with members, physicians, drug manufacturers, and pharmacies to facilitate enrollment in savings programs.
  • Manage every call by accurately resolving the issue, demonstrating compassion, meeting compliance requirements, and ensuring a hassle-free experience for our Members
  • Provide empathetic support to patients by phone, email, and other channels
  • Maintain impeccable documentation, responsiveness, timeless of response with follow-up of each member call
  • Have a patient-centric mindset and a high sense of urgency to solve requests
  • Work with sensitive information while upholding PHI and HIPAA standards.
  • Stay updated on organizational processes and policies to maintain compliance and ensure service quality.
  • Organize case details per required standards and keep track of multiple tasks to ensure optimal productivity in a fast paced environment.
  • Achieve or exceed specific key performance indicators and meet service level expectations to maintain high-quality service standards.
  • Consistently maintain quality assurance standards and strict adherence to schedule, contributing to the overall efficiency and reliability of support.
  • Other Duties as assigned

SmithRx operates as a Pharmacy Benefit Manager (PBM) that focuses on managing prescription drug plans for self-insured employers and plan sponsors. The company uses a transparent pricing model called "Pass Through Pricing," where it charges only an administrative fee and passes all rebates from prescriptions directly to clients and their members. This model contrasts with traditional PBMs that often inflate drug prices and retain rebates for profit. SmithRx's clients benefit from a technology platform that utilizes real-time data to improve service delivery, ensuring efficient and high-quality pharmacy benefit management. The company also provides a concierge service to enhance support for both members and clients. By prioritizing transparency, advanced technology, and exceptional customer service, SmithRx aims to simplify pharmacy benefits and maximize value for its clients.

Company Stage

Series C

Total Funding

$98.7M

Headquarters

San Francisco, California

Founded

2016

Growth & Insights
Headcount

6 month growth

5%

1 year growth

24%

2 year growth

242%
Simplify Jobs

Simplify's Take

What believers are saying

  • SmithRx's recent $60M Series C funding led by Venrock positions the company for significant growth and innovation in the PBM market.
  • The partnership with Banjo Health to revolutionize prior authorization processes demonstrates SmithRx's commitment to leveraging cutting-edge technology for improved efficiency and transparency.
  • SmithRx's collaboration with TheracosBio to offer newly approved diabetes drugs highlights its dedication to providing cost-effective and essential medications to its members.

What critics are saying

  • The PBM market is highly competitive, and SmithRx must continuously innovate to maintain its unique value proposition.
  • Reliance on the 'Pass Through Pricing' model may limit revenue growth compared to traditional PBMs that profit from rebates and hidden fees.

What makes SmithRx unique

  • SmithRx's 'Pass Through Pricing' model ensures complete transparency by passing 100% of rebates to clients, unlike traditional PBMs that profit from hidden fees and inflated drug prices.
  • The company's robust technology platform leverages real-time data to enhance service offerings, setting it apart from competitors who may rely on outdated systems.
  • SmithRx's concierge service provides exceptional support to both members and customers, further distinguishing it from other PBMs that may lack personalized customer care.
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