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Healthcare Access Specialist
2 months ago
Pride Health is currently in search of a Healthcare Access Specialist to support our esteemed pharmacy benefits client.
Position Type: Remote - US
Compensation: $18/hr
Work Schedule: Monday through Friday
Training Hours: 8:30am-5:30pm EST
Regular Working Hours: 8:30am-5:30pm EST
Key Responsibilities:
- Address incoming inquiries and general program-related questions.
- Assess eligibility for various support programs (e.g., Copay, Patient Assistance Programs, Medicaid).
- Facilitate pharmacy services, including triage and order management.
- Perform follow-up tasks such as gathering missing information or prior authorizations.
- Document and report adverse events as instructed.
- Investigate and resolve claim denials or underpayments in a timely manner.
- Collect necessary information through phone, fax, mail, and online channels.
- Deliver outstanding customer service, ensuring requests are resolved accurately and promptly.
- Identify and report trends or delays to program management (e.g., billing denials, claim issues).
- Ensure all program communications adhere to quality standards.
- Collaborate with patients, healthcare providers, and internal teams to ensure documentation compliance.
Qualifications:
- High school diploma or GED is mandatory.
- A minimum of 3 years of experience in medical billing, customer service, or related fields is required.
Pride Health is a prominent minority-owned healthcare recruitment and staffing agency that provides tailored business process solutions at competitive rates. With headquarters in New York City, Pride Health stands out as a leading minority supplier, boasting a wide geographic presence with offices across the U.S., India, and Brazil.
With over 20 years of expertise, Pride Health has refined its core competency in IT staffing services, delivering client-focused, cost-effective IT and business process solutions. We serve Client-Partners across various sectors, including healthcare, IT, financial services, retail, and insurance, offering both Direct Hire and Temporary Staffing solutions for Healthcare Professionals, Vendor Management Systems, IT Hardware Procurement Services, and Business Process Outsourcing.
Our staffing solutions encompass Temporary, Contract, Per Diem, and Direct Hire options, ensuring we meet the diverse needs of our clients.
