Alnylam
Associate Case Manager
Alnylam, Cambridge, Massachusetts, us, 02140
Overview
Our Patient Services team provides exceptional customer service on all levels. The Associate Case Manager role is an integral component of the commercial strategy and responsible for working collaboratlively with Case Managers to complete tasks that will provide access and therapy management services for Alnylam's portfolio of products. Reporting to Regional Manager, US Patient Services, the Associate Case Manager will be responsible for a variety of day-to-day operations.The primary responsibilities will be interfacing with payers to facilitate access to treatment.The ACM will support reimbursement responsibilities which would include, but are notlimited to performing benefit verifications, investigating prior authorization requirements orprior authorization follow-up with payers. The ACM will also be responsible for entering allInbound Requests into the Patient Services Customer Relationship Management (CRM)system, maintaining proper documentation and coordinate workflow with the CaseManagement Team.The successful candidate must possess superb attention to detail with a high degree ofaccuracy. He/She must always demonstrate an empathetic and professional demeanor. TheACM demonstrates understanding of the department business objectives and measures anddemonstrates ability to work independently as well as collaboratively within a highly matrixed environment.The description below is not intended to provide an all-inclusive listing of duties and responsibilities. Duties may change at the discretion of management, and/or management may request duties be performed that are not listed.Key ResponsibilitiesVerify and re-verify insurance coverage policies and benefit details through direct contact with payersReceive incoming referrals from providers, via fax queue (or other means)Maintain workflow of clearing, sorting, and distribution of incoming faxesAbility to prioritize work duties to maintain customer satisfaction through prompt and efficient serviceAccurately interprets patient insurance, prescription, and other health related documentationEnter and maintain accurate data on individuals, their insurance, and all payer interactionsSend Summary of Benefits to Providers and Field Reimbursement DirectorsResearch and identify payer Prior Authorization Processes and obtain necessary documents and requirements to disseminate to Case Management TeamSubmit and Track referrals to Specialty Pharmacies, as neededMaintain up-to-date knowledge of the reimbursement process, billing/coding guidelines, healthcare policy, payer trendsParticipate in projects and/or assignments including, but not limited to, QC initiatives, interdepartmental projects, etc.Demonstrate adaptability and flexibility; seek out opportunities to support your teammatesNavigate customer-relationship management (CRM) platform in daily interations and learn internal team processes for full understanding of Alnylam's Patient ServicesMaintain confidentiality of patient health information and act in compliance with all laws, regulations, and Alnylam Company policiesOutreach to Sites of Care related to initial and ongoing treatmentQualificationsBachelor's Degree required1-2 years of experience with customer service, account management, case management, or healthcare field experience
rare disease experience preferred
Knowledge of private payer, Medicare, and Medicaid structure, systems, reimbursement process and medical terminologyExperience working in a high-volume patient services program preferredEffective communication, ability to think critically and problem solveWillingness to learn and adapt quickly in a fast-paced environmentAbility to work cooperatively as a team member and have well-developed interpersonal skillsSelf-starter who is highly passionate about rare disease and Alnylam's core values:
Commitment to People, Innovation, Discovery, Sense of Urgency, Open Culture, and Passion for Excellence
Familiar with Microsoft Suite and Salesforce CRM preferred>
Our Patient Services team provides exceptional customer service on all levels. The Associate Case Manager role is an integral component of the commercial strategy and responsible for working collaboratlively with Case Managers to complete tasks that will provide access and therapy management services for Alnylam's portfolio of products. Reporting to Regional Manager, US Patient Services, the Associate Case Manager will be responsible for a variety of day-to-day operations.The primary responsibilities will be interfacing with payers to facilitate access to treatment.The ACM will support reimbursement responsibilities which would include, but are notlimited to performing benefit verifications, investigating prior authorization requirements orprior authorization follow-up with payers. The ACM will also be responsible for entering allInbound Requests into the Patient Services Customer Relationship Management (CRM)system, maintaining proper documentation and coordinate workflow with the CaseManagement Team.The successful candidate must possess superb attention to detail with a high degree ofaccuracy. He/She must always demonstrate an empathetic and professional demeanor. TheACM demonstrates understanding of the department business objectives and measures anddemonstrates ability to work independently as well as collaboratively within a highly matrixed environment.The description below is not intended to provide an all-inclusive listing of duties and responsibilities. Duties may change at the discretion of management, and/or management may request duties be performed that are not listed.Key ResponsibilitiesVerify and re-verify insurance coverage policies and benefit details through direct contact with payersReceive incoming referrals from providers, via fax queue (or other means)Maintain workflow of clearing, sorting, and distribution of incoming faxesAbility to prioritize work duties to maintain customer satisfaction through prompt and efficient serviceAccurately interprets patient insurance, prescription, and other health related documentationEnter and maintain accurate data on individuals, their insurance, and all payer interactionsSend Summary of Benefits to Providers and Field Reimbursement DirectorsResearch and identify payer Prior Authorization Processes and obtain necessary documents and requirements to disseminate to Case Management TeamSubmit and Track referrals to Specialty Pharmacies, as neededMaintain up-to-date knowledge of the reimbursement process, billing/coding guidelines, healthcare policy, payer trendsParticipate in projects and/or assignments including, but not limited to, QC initiatives, interdepartmental projects, etc.Demonstrate adaptability and flexibility; seek out opportunities to support your teammatesNavigate customer-relationship management (CRM) platform in daily interations and learn internal team processes for full understanding of Alnylam's Patient ServicesMaintain confidentiality of patient health information and act in compliance with all laws, regulations, and Alnylam Company policiesOutreach to Sites of Care related to initial and ongoing treatmentQualificationsBachelor's Degree required1-2 years of experience with customer service, account management, case management, or healthcare field experience
rare disease experience preferred
Knowledge of private payer, Medicare, and Medicaid structure, systems, reimbursement process and medical terminologyExperience working in a high-volume patient services program preferredEffective communication, ability to think critically and problem solveWillingness to learn and adapt quickly in a fast-paced environmentAbility to work cooperatively as a team member and have well-developed interpersonal skillsSelf-starter who is highly passionate about rare disease and Alnylam's core values:
Commitment to People, Innovation, Discovery, Sense of Urgency, Open Culture, and Passion for Excellence
Familiar with Microsoft Suite and Salesforce CRM preferred>