JOB SUMMARY
DUTIES AND RESPONSIBILITIES
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Gather all pertinent and appropriate information from the chart to complete the necessary forms (private and/ or provincial insurance) in a concise, organized, and professional manner.
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Liaise and advocate with insurance providers and provincial governments as necessary to determine coverage options.
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Keep detailed notes in the patient's electronic chart.
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Follow-up/ advocate until a decision is received to secure coverage for the patient.
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Completes and/ or reviews SA forms prior to submission to insurers.
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Proactively offer financial assistance for patients.
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Act as a resource for program stakeholders, which include physicians, nurses, patients and clinics and the client.
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Assist with data integrity/ rounds as required.
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Participate in ongoing internal and/ or external continuing education activities.
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Adhere to Bayshore Policies and Procedures.
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Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System.
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Employee will maintain relevant level of knowledge of ICH (International Conference of Harmonization), GCP (Good Clinical Practice) and Health Canada GVP (Good Pharmacovigilance Practices) guidelines appropriate to their hired role which is to be provided at the time of hire and
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Must be able to identify and report AEs to Health Canada, Med Info and enter into source system
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Participate in processes relating to regulatory reporting requirements.
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Participates in proactive Health \& Safety activities while performing all duties. Is responsible to notify immediate supervisor of any Health \& Safety risks or concerns. Responsible for completing Accident Reports for all direct reports who injure themselves on the job, within 24 hours of the
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Maintains confidentiality of client and corporate information and discusses same only with
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Complete other tasks as requested
Qualifications QUALIFICATIONS
- Familiarity with PEPEDA and how it applies in a confidential patient environment.
- Minimum 2 years of Canadian public and private reimbursement navigation and advocacy experience, within a patient program environment, ideally with PA/SA drugs for chronic diseases.
- Understanding of provincial and private coverage criteria
- Familiarity with the Special Authorization process for both public and private insurance.
- Strong computer and software skills: Excel, Word, Outlook, Adobe Acrobat, CRM database entry, VOIP telephony, web portals, teleconferences, web-based meetings.
- Ease with working independently, "playing detective," making decisions using sound judgment, and meeting deadlines.
- Ease with working in a paperless environment.
- Excellent written and verbal communication skills in English and French is an required.
- Familiarity with PIPEDA and how it applies in a confidential patient environment.
Bayshore HealthCare
