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Patient Care/ Reimbursement Specialist - Mississauga ON



Ontario, CA, USA
Posted on Saturday, May 6, 2023
Who We AreEstablished in 2007, NKS Health is a specialty pharmacy and healthcare company focused on the handling and service of injectable, infused and biologic medications. NKS Health provides high quality service by strategically focusing on chronic autoimmune and neurological conditions, such as: rheumatoid arthritis, gastrointestinal diseases, dermatological diseases, stroke rehabilitation, migraines, and multiple sclerosis. An organizational dedication to program innovation and R&D has allowed NKS Health to design and deliver superior healthcare solutions over the years, which has earned them a premium reputation with patients, physicians, and medication manufacturers. NKS Health truly creates a complete patient experience as it works with patients, physicians, clinics, hospitals, and nursing homes on all aspects of treatment.We are a premier specialty pharmacy services provider, offering innovative programs, exceptional service, and superior value. For our patients, we are committed to achieving better health... NKS Health.We are looking for a Full-time Patient Care/ Reimbursement Specialist to join our growing specialized pharmacy operations in Mississauga, ON.Under the direction of the Biologic Manager, the Patient Care Coordinator is responsible for managing all aspects of onboarding patients for assigned physicians in a given geographical area or hospital. The individual will work directly with the physicians and or the office staff to provide proactive and seamless services with respect to onboarding new patients. This role is performed both in our offices and in the field.PRIMARY DUTIES AND RESPONSIBILITIES:
  • Be the single point of contact with physician(s)
  • Communicate within the pharmacy team to assist with patient care
  • Provide ongoing updates to MDs on patient status
  • Follow up with MD to insure patient status updates are shared
  • Accurate and timely patient charting in CRM
  • Proactively provides assistance to resolve client issues with regards to assigned physicians
  • Manage all patient starts from time of enrollment to start of therapy
  • Single point of contact for patients enrolled in the support program and prescribing physician, if applicable
  • Conducts welcome calls to gather relevant information, introduces patients to the support program, and obtains patient consent as required
  • Informs the patient about all program offerings – for example case management support, reimbursement support, self-injection training, prescription coordination and ongoing compliance
  • Understands the molecule(s) in full detail
  • Maintains an expert level of knowledge of reimbursement mechanisms in the public and private arenas, specifically within assigned territory
  • Acts as a patient advocate, exploring all options for funding of medications, determines coverage details and develops/maintains complete and accurate documentation required to facilitate a successful outcome of the reimbursement process
  • Administers financial means tests and manages all aspects of financial assistance within the program as applicable
  • Ensures coordination of program services to patients in an effective manner resulting in prompt and continued access to therapy; including self-injection training
  • Works collaboratively with Program Management, other Patient Care Specialists, and Field Case Manager/Case Manager (program dependent) to address patients concerns or needs and escalations interrupting the patient journey
  • Contact clients periodically to confirm adherence and coordinate delivery of medications (including date, time)
  • Report all adverse Events (AE) and Product Technical complaints (PTC) immediately or as soon as possible upon becoming aware of the event as per current policies and procedures
  • College Diploma or University degree is required
  • 2-3 years’ experience in the healthcare or pharmaceutical industry, preferably working with directly with patients and with other health professionals (i.e. physicians, nurses, pharmacists)
  • Experience with public (provincial and federal) and private third party drug reimbursement plans
  • 2-3 years’ experience in a Customer Service or Call Centre setting
  • Strong Computer skills in a Windows environment using MS Office and experience using a customer relationship database is an asset
  • Demonstrated ability to work successfully within a fast paced, team based environment
  • Excellent communication skills, written and verbal, to interact effectively with patients and clients
  • Demonstrated ability to analyze and interpret information, data, and regulations
  • Demonstrated ability to pay attention to details and make decisions using sound judgement
  • Flexible to work longer hours, overtime as required
  • Able to work flexible hours between 8:00AM to 8:00PM

  • Superior customer service skills
  • Demonstrated teamwork abilities
  • Ability to manage multiple tasks and priorities at once
  • Comprehension of medical terminology, Ability to read and interpret patient charts
  • Strong analytical skills including interpretation of regulation and legislation
  • Ability to make decisions using sound judgment
  • Ability to work autonomously
  • Strong organizational skills, creative problem solving and results oriented
  • Strong time and project management skills and sense of urgency
  • Ability to analyze current enrollment volume by MD
  • Ability to analyze enrollment potential based on prescription volume of other biologics
  • Ability to engage with a physician and his/her staff as a trusted and well-informed medical counterpart
  • Must have a valid driver’s license and possess a car
  • Ability to conduct Continuous Healthcare Education (CHE) events with HCPs, which may occur outside regular business hours
  • Can interact with multiple sales reps and district managers from the commercial team
  • Superior verbal and written communication skills, interpersonal skills and
  • Attention to detail
  • Ability to speak multiple languages an asset
  • Established relationships with Customers in a given territory, an asset
  • Knowledge of public, private and federal reimbursement an asset
  • Hold and maintain a valid, non-expired, unrestricted driver’s license

  • GreenShield means, collectively, Green Shield Canada (GSC), Green Shield Association, and Green Shield Holdings Inc., which is the primary company that houses health services and benefits administration businesses, including Inkblot Therapy, Tranquility, NKS Health Canada, The Health Depot Pharmacy, Benecaid, Honeybee, BCH Consultants and Computer Workware Inc. Green Shield Holdings Inc. is a wholly owned subsidiary of the not-for-profit Green Shield Association