Patient Access Specialist
About The Position
The Patient Access Specialist is responsible for processing applications, introducing the assistance program, conducting benefit investigation for patients, and navigating complex reimbursement issues including initial entry of patient data into the system, looking up insurance benefits, contacting insurers, advising the healthcare provider and/or patient of patients’ benefits, and identifying patient access barriers and seeking resources to overcome barriers; leading and participating in pilots, new initiatives, special projects, and cross functional teams. Answers inbound calls and makes outbound calls to introduce services. Gathers patient data, addresses the needs of the patient and reviews insurance benefits. Records the call details in patient data system. Contacts insurers for verification o fbenefits. Handles difficult patient situations when they arise. Conducts follow-up with pharmacies. Performs other related duties as assigned by management. Identify and report adverse events pursuant to program requirements. Identify, document, and report safety information. May need to take and receive calls.
Requirements
- Associate degree (AA) or equivalent from a two-year college or technical school, or six months to one-year related experience and/or training, or equivalent combination of education and experience.
- Computer skills: Microsoft Office Suite.
Nice To Haves
- 2 to 4 years of benefit investigation involving the analysis and interpretation of insurance coverage
- 2 to 4 years of experience interacting with healthcare providers regarding health insurance plan requirements
- Pharmacy background/call center/health insurance or MD office experience
- Exposure to enrollment, pre-assessment & benefits' processes
- Part D claim experience
Responsibilities
- Processing applications
- Introducing the assistance program
- Conducting benefit investigation for patients
- Navigating complex reimbursement issues
- Initial entry of patient data into the system
- Looking up insurance benefits
- Contacting insurers
- Advising the healthcare provider and/or patient of patients’ benefits
- Identifying patient access barriers and seeking resources to overcome barriers
- Leading and participating in pilots, new initiatives, special projects, and cross functional teams
- Answering inbound calls and making outbound calls to introduce services
- Gathering patient data
- Addressing the needs of the patient
- Reviewing insurance benefits
- Recording the call details in patient data system
- Contacting insurers for verification of benefits
- Handling difficult patient situations
- Conducting follow-up with pharmacies
- Performing other related duties as assigned by management
- Identifying and reporting adverse events pursuant to program requirements
- Identifying, documenting, and reporting safety information
- Taking and receiving calls
Benefits
- Competitive pay structure
- Matching 401(k) with immediate vesting
- Medical, dental, vision, life, & short-term disability insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
