Susan Stout

• Provide consistent and effective communication to all appropriate stakeholders as first line support/single point of contact with contracted specialty pharmacies and/or specialty distributors.

• Identify, investigate, and resolve escalated issues and cases related to complex reimbursement and/or REMS compliance from both internal and external stakeholders.

• Responsible for analyzing incoming data and recognizing trends and cases that need further action.

• Review all incoming daily data from the contracted SPs and/or SDs, review exception errors generated from each contracted data feed, and outreach to contracted SPs and/or SDs related to outstanding restatements. Ensure all contractual timeframes related to SP and/or SD data review are successfully met, as applicable.

• Lead weekly (more or less frequently as needed) calls with each contracted SP and/or SD to review identified issues with shipment files and/or patient status files to include those patients at risk of lapsing in therapy, shipment and/or insurance delays, missing shipment and updates.

• Triage records, in a timely and accurate manner, if applicable to the program.

• Provide timely tracking of receipt of referral, status of contracted SP activity, and potential interruptions in therapy.

• Provide training and education to contracted SPs and/or SDs about the program, processes, and data requirements.

• Gathers, analyzes, and prepares data, for Quarterly Business Reviews (QBRs), Compliance Committee Meetings, FDA requirements, and other special projects and reports as applicable.

• Attends manufacturer national sales conferences as applicable.

• Attends manufacturer/SP QBRs and other manufacturer meetings as requested.

• Review incoming referrals for completeness of and confirm FDA requirements are met as applicable. These are typically received via facsimile, Web portal or client partner download.

• Answer all Incoming calls quickly and efficiently, evaluate their need and respond or disseminate call to appropriate member of team.

• Provide assistance with reimbursement inquiry requests, including insurance benefit verification, prior authorization, denials and appeals, and other reimbursement issues from patients, MDOs, payers and Sales Representative

• May provide billing and coding information related to specific product(s)

• Conduct general payer research

• Investigation of benefits and eligibility by phone and/or internet to determine coverage choices patient has in starting therapy.

• Participate in call center activities, triage, and respond to incoming calls from patients, insurance companies, physicians, sales representatives, pharmacies, and homecare agencies.

• May serve as single point of contact for an assigned group of prescribers.

• Effectively manage and work though action item list to ensure it is current and tasks are completed in a timely fashion.

• Maintain accurate and complete documentation of all inquiries in order to continuously improve the customer service process and reduce potential legal concerns.

• Identify and escalate repetitive questions and/or problems so that corrective action can be pursued and expedited.

• Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.

• Other duties as assigned.

• Handle inbound and outbound contacts from various sources (patients, healthcare providers, etc.) related to a specific and/or multiple UBC programs, as applicable.
• Provide consistent customer service support to all stakeholders for the assigned program(s).
• Working knowledge of program guidelines, medication, or disease being referenced in call scripts.
• Conduct communication through various channels (phone, fax, email) to retrieve data or to address discrepancies in data received.
• Complete full follow-up with regards to missing information from stakeholders, including data entry process, as applicable, documentation, and safety reporting per program guidelines.
• Apply corrections and/or updates in the secured program applications and/or CTMS and appropriate documents, which have been identified through data verification or follow-up calls.
• Escalate potential problems or issues that require management’s immediate attention and provide a summary with appropriate detail to his/her direct supervisor.
• Document all communications in the appropriate application contact log in an accurate, concise, and timely manner as defined in the Standard Operating Procedures and/or Project Specific Procedures.
• When applicable, may assist in the process to recruit or initiate sites and coordinate launch activities.
• Ensure all assigned project tasks are completed.
• Provide new and/or updated training materials as needed.
• Responsible for ensuring all program compliance duties (including re-education of stakeholders, documentation of non-compliant event, review of alerts/reminders, and healthcare provider follow-up) are completed.
• When applicable, may be responsible for preparation of program compliance materials for client meetings.
• When applicable, may be responsible for preparation and shipping of program materials and documenting action within the appropriate application/s.
• When applicable, may be responsible for processing honorarium.
• Review documents for program standards and take appropriate action.
• Ensure data entry, filing, and data confirmation are completed accurately and in a timely manner, as applicable.
• Other duties as assigned by the Program Manager, Associate Program Manager, Associate Manager, Coordinating Center, and/or Senior Manager, Coordinating Center and as determined by UBC SOPs.

• Review incoming referrals for completeness of and confirm FDA requirements are met as applicable. These are typically received via facsimile, Web portal or client partner download.

• Answer all Incoming calls quickly and efficiently, evaluate their need and respond or disseminate call to appropriate member of team.

• Provide assistance with reimbursement inquiry requests, including insurance benefit verification, prior authorization, denials and appeals, and other reimbursement issues from patients, MDOs, payers and Sales Representative

• May provide billing and coding information related to specific product(s)

• Conduct general payer research

• Investigation of benefits and eligibility by phone and/or internet to determine coverage choices patient has in starting therapy.

• Participate in call center activities, triage, and respond to incoming calls from patients, insurance companies, physicians, sales representatives, pharmacies, and homecare agencies.

• May serve as single point of contact for an assigned group of prescribers.

• Effectively manage and work though action item list to ensure it is current and tasks are completed in a timely fashion.

• Maintain accurate and complete documentation of all inquiries in order to continuously improve the customer service process and reduce potential legal concerns.

• Identify and escalate repetitive questions and/or problems so that corrective action can be pursued and expedited.

• Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.

• Other duties as assigned.