Account Care Educator - Specialty Pharmacy

AssistRx•Maitland, FL

28d•Onsite

About The Position

This role works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product. You will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. You will be the single point of contact for questions and inquiries from the prescriber, patient, and field agent by territory. You will identify applicable programs and facilitate next steps, holistically communicating the statuses of all patient support activities. You will act as a liaison with other program-specific Assist resources to secure outcomes for active patients. You will accept inbound calls for your assigned territory or overflow of other territories and provide one call resolution support, ensuring protection is insured. Performs other related duties as assigned by management.

Requirements

College degree is preferred or high school diploma or equivalent combination of education and experience.
Previous work experience in Medical Reimbursement or Customer Service.
Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications, and keyboard skills.
Demonstrated strong written and verbal communication skills with providers, patients and insurance companies.
Interpersonal skills to facilitate work with a wide range of individuals and groups from culturally diverse publics.
Problem solving skills.

Nice To Haves

Possible hybrid option being offered once criteria is met.

Responsibilities

Works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product.
Support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues.
Single point of contact for questions and inquiries from the prescriber, patient, and field agent by territory.
Identifies applicable programs and facilitates next steps.
Holistically communicates the statuses of all patient support activities.
Liaison with other program-specific Assist resources to secure outcomes for active patients.
Accepts inbound calls for assigned territory or overflow of other territories and provides one call resolution support.
Ensures protection is insured.
Performs other related duties as assigned by management.
Submitting billing data to appropriate insurance providers
Processing claims and resolving denial instances
Achieving maximum reimbursement for services provided
Completing Medicare and Commercial insurance claim submission.
Documenting and reporting payment information.

Benefits

Supportive, progressive, fast-paced environment
Competitive pay structure
Matching 401(k) with immediate vesting
Medical, dental, vision, life, & short-term disability insurance
Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary.
Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary.
Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications.
Flexible Culture: Many associates earn the opportunity to work from home after 120 days. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives.
Career Growth: We prioritize a “promote from within mentality”. We invest in our employees’ growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization.
Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry.
Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible.
$750 referral bonus