Nurse Patient Access Specialist (RN/LPN) -Remote
About The Position
The Nurse Patient Access Specialist serves as the primary point of contact for patients, healthcare providers, and field representatives within a Patient Support Services (PSS) program. This role is responsible for facilitating patient access to therapy by conducting benefit investigations, verifying insurance eligibility, supporting prior authorizations and appeals, and assisting with copay and patient assistance programs. Bilingual Clinical Care Managers may also discuss the patient’s disease state and treatment options. Nurse Patient Access Specialist support patients throughout their treatment journey while ensuring a high level of service, compliance, and coordination across stakeholders.
Requirements
- Licensed Practical Nurse or Registered Nurse with 1 year post registration experience; or equivalent of education, training and experience with previous experience providing patients with education on self-injections or use of injectable devices.
- 3–5+ years of experience in medical billing, reimbursement, or insurance verification
- Robust understanding of payer coverage and reimbursement (medical and pharmacy)
- Experience in a contact center or patient support environment
- Proficiency with Microsoft Office and CRM systems
- Strong written and verbal communication skills
- High attention to detail and multitasking ability
- Ability to work independently in a virtual environment
- Problem-solving and solution-oriented mindset
- Knowledge of HIPAA and data privacy requirements
- Must reside in the country where the role is posted
Nice To Haves
- Licensed Practical Nurse or Registered Nurse with previous case/care manager experience in the hematology field and/or rare diseases.
- Experience in a Patient Support Services (Hub) environment with focus on rare diseases
- Healthcare or pharmaceutical customer service experience
Responsibilities
- Support clinical discussions with patients regarding the disease state and products supported by the program.
- Provide patient education on self-injections or use of injectable devices in accordance with program SOPs
- Serve as the primary point of contact for patients, providers, and stakeholders
- Conduct inbound and outbound calls to support program services
- Perform insurance benefit investigations and verify coverage
- Support prior authorizations and appeals processes
- Assist with copay and patient assistance program enrollment
- Provide ongoing patient support and adherence coordination
- Document all interactions accurately and timely
- Deliver high-quality customer service across communication channels
- Collaborate with field representatives and internal teams
- Manage patient caseloads with timely follow-up
- Ensure compliance with HIPAA and regulatory requirements
- Identify and report adverse events and product complaints
- Troubleshoot issues and escalate as needed
- Maintain knowledge of program policies and processes
- Support onboarding and training of new employees
- Meet quality standards and KPIs
- Perform additional duties as assigned
Benefits
- health and welfare and/or other benefits
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
