Healthcare Access Coordinator

2 weeks ago

Gaithersburg, Maryland, United States Artech Information System LLC Full time
Position Overview:
This role is dedicated to managing a variety of patient access scenarios, including intricate reimbursement challenges.
It involves providing comprehensive education and resources to facilitate optimal patient access to therapies.
Additionally, the position entails handling patient cases that are part of the Access 360 initiative.


The focus will be on identifying access obstacles and delivering prompt support by offering information and resources to mitigate reimbursement access challenges while fostering robust internal and external communication.


Key Responsibilities:
- Oversee daily operations related to healthcare provider support requests and deliverables.
- Conduct case intake and document all pertinent information in the Access 360 Case Management system.
- Ensure that all support requests are accurately recorded within the Case Management system.
- Guarantee timely processing and resolution of cases.
- Appropriately escalate cases to the Patient Access Associate team as needed.

Coordinate all relevant aspects of patient case management until resolution, utilizing effective interpersonal skills to manage interactions with Access 360 PAA staff.

Act as a primary contact for healthcare providers and patients, leveraging regional reimbursement, distribution, and payer policy expertise to devise solutions for complex patient access scenarios, collaborating closely with the PAA team to escalate and resolve issues effectively.

Educate healthcare offices on Access 360 programs and the referral process to ensure efficient case processing.

Qualifications:
- Associate's Degree or equivalent education in health sciences, managed healthcare, public policy, social work, or related fields.

- A minimum of 2 years of experience in healthcare or healthcare reimbursement; a high level of proficiency in all aspects of reimbursement and access, including benefit investigations.

- Familiarity with specialty pharmacy distribution.
- Knowledge of private and public payer reimbursement policies and procedures.
- Understanding of regulatory and administrative guidelines.
- Coordination of patient access experience.

- In-depth knowledge of specialty products, reimbursement for medical and pharmacy benefits, patient access processes, and patient assistance programs, including operational policies and procedures.

- Proven ability to consistently meet or exceed qualitative and quantitative targets and goals.
- Experience with HIPAA regulations, patient access data, and analytics.
- Willingness to travel for regular internal and external business meetings.
- Flexibility to work specific shift hours.

Preferred Qualifications:
- Bachelor's degree, RN, BSN, or equivalent education in health sciences, managed healthcare, public policy, social work, or related fields.

- At least 3 years of experience in healthcare or healthcare reimbursement; a high level of proficiency in all aspects of reimbursement and access, including benefit investigations, specialty pharmacy distribution, and knowledge of private and public payer reimbursement policies.

- Relevant experience in biologics healthcare/insurance.
- Background in billing/coding in buy and bill and specialty pharmacy markets.
- Ability to drive projects and cases to completion, be self-directed, and possess excellent verbal and written communication skills.
- Strong analytical thinking, problem-solving, and decision-making abilities.
- Effective organizational management skills.
- Proficient in Microsoft Word, Excel, and PowerPoint.
- Capability to multitask and manage multiple concurrent projects.
- Business acumen; knowledgeable about current and potential future policies, practices, trends, technology, and information affecting Access Services programs.

Additional Information:
All information will be kept confidential according to EEO guidelines.

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