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Role Description

The Patient Experience Coordinator at Fuze Health plays a key role in supporting Central Operations by delivering exceptional customer service, managing patient inquiries, and ensuring accurate and timely communication across departments. Reporting to Central Operations leadership, this role is essential to maintaining patient satisfaction, operational efficiency, and high-quality service standards within FuzeRx.

• Customer Inquiry Management: Respond to all patient and customer inquiries through phone, messaging, and internal systems, providing accurate information and timely resolutions.
• Issue Resolution: Review and resolve escalated problem orders to identify root causes and implement effective solutions.
• Patient Communication: Interact with patients regarding prescription claims, order status, and shipping updates with professionalism and empathy.
• Call Handling: Manage inbound calls from patients, insurance partners, and customers; route calls to appropriate departments as needed.
• Cross-Functional Collaboration: Work closely with internal teams to ensure smooth workflows and provide operational support when needed.
• Customer Service Excellence: Maintain a positive, empathetic, and professional attitude in all interactions to promote a patient-first experience.
• Performance Achievement: Strive to exceed key performance indicators (KPIs) and service-level expectations for both internal and external partners.
• Adaptability & Growth: Demonstrate flexibility in a fast-paced environment and embrace new challenges and opportunities for professional development.
• Billing Functions: Perform comprehensive pharmacy billing functions across both pharmacy and medical benefits.
• Benefits Investigation: Conduct benefits investigations to verify patient coverage, eligibility, and reimbursement requirements.
• Prior Authorization Submission: Prepare and submit prior authorizations (PAs) in accordance with payer-specific guidelines and timelines.
• Claims Adjudication: Manage claims adjudication processes, including review, troubleshooting, and resolution of rejected or denied claims.
• Copay Assistance: Coordinate and support patient access through copay assistance programs and other financial support resources.

Qualifications

• High School Diploma or GED equivalent required.
• 1+ year of customer service experience (healthcare or pharmacy experience preferred).
• Strong phone and messaging etiquette with a proven ability to deliver outstanding customer support.
• Excellent written and verbal communication skills for effective interaction with patients, customers, and team members.
• Detail-oriented with strong organizational and problem-solving abilities.
• Ability to work collaboratively in a team environment and build strong professional relationships.
• Self-driven and comfortable working with complex systems in a remote work environment.
• Adaptable to change and capable of managing multiple priorities in a fast-paced setting.
• Experience in pharmacy-related customer service (preferred).

Benefits

• The compensation range for this position is $19.00-$22.00/hour.
• Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from.
• 401(k) retirement savings plan.
• Group life insurance, accidental death and dismemberment (AD&D) insurance.
• Flexible spending account (FSA) and health savings account (HSA).
• Commuter benefits.
• Employer-paid short-term (STD) and long-term disability (LTD) insurance.
• Additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program).
• Flexible vacation time, accrued paid sick time, 10 paid holidays, and 2 floating holidays for full-time non-exempt employees.
• Eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, and 4 weeks paid caregiver leave.
• A Lifestyle Spending Account allowance each month.