Patient Access Coordinator
19 hours ago
Job Summary:
The Patient Access Specialist plays a critical role in ensuring patients have access to the medications and therapies they need. This position works closely with healthcare providers, patients, payors, and pharmacies to gather information about a patient's insurance policy and the coverage provided by that policy for a specific pharmaceutical product.
Key Responsibilities:
- Conduct benefit investigations for patients by making outbound phone calls to payors to verify patient insurance benefit information, navigate complex reimbursement barriers, and seek resources to overcome the barriers.
- Verify patient-specific benefits and document specifics, including coverage, cost share, and access/provider options.
- Identify any coverage restrictions and details on how to expedite patient access.
- Document and initiate prior authorization processes and claims appeals.
- Report any reimbursement trends or delays in coverage to management.
- Assign appropriate cost-sharing solutions or assess and refer patients to special programs/services as needed.
- Communicate the results of benefit investigations to healthcare providers and patients in a timely and accurate manner.
Requirements:
- High School Diploma required; Associate's or Bachelor's Degree in Science, Finance, or Business preferred.
- 3-5 years of benefit investigation experience involving the analysis and interpretation of insurance coverage.
- 3-5 years of experience interacting with healthcare providers regarding health insurance plan requirements.
- Pharmacy background, call center, or MD office experience preferred.
- Excellent verbal communication skills and grammar.
- Computer literacy/competence.
Preferred Qualifications:
- 2-3 years of claims, health insurance benefits, or healthcare billing experience.
- SalesForce system experience.
Work Schedule:
Monday to Friday, 8am-5pm (1 hour lunch), 9am-6pm (1 hour lunch), 10am-7pm (1 hour lunch), or 11am-8pm (1 hour lunch).
Training:
September 9 – September 27, 8:30-4:30 EST. A 1-hour paid lunch break is provided during the three weeks of training.
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