Patient Support Specialist, Patient Solutions & Support Programs

Merck•Boston, MA

About The Position

The Patient Support Specialist delivers prompt, professional phone assistance to patients, caregivers, and providers regarding specialty medication enrollment, access barriers, and affordability solutions, with a target of first-call resolution. The role guides stakeholders through benefit investigations, prior authorizations, appeals, copay assistance, and financial aid programs to clarify coverage and out-of-pocket costs. It serves as a primary contact for complex reimbursement challenges, using root-cause analysis to provide solution-focused resolutions. The specialist collaborates with insurance verification vendors, internal partners, and cross-functional teams to streamline workflows and maintain operational alignment. The role requires strict adherence to HIPAA and regulatory requirements, with thorough documentation of case interactions, patient data, and coverage updates. It also provides informal mentorship and procedural guidance to Patient Support Specialists, identifies operational bottlenecks and improvement opportunities, and assists leadership with case reviews, performance metrics, service consistency, and compliance. The specialist helps communicate performance updates, operational changes, and improvement areas between frontline staff and management while fostering an inclusive, patient-first environment. The schedule is Monday through Friday, 11:30 a.m. to 8:00 p.m. The role does not offer work-authorization sponsorship; external applicants must be eligible to work in the United States. The pay range is $30–$47 per hour. The position may be eligible for sales or performance-based bonuses.

Requirements

Bachelor’s degree in any discipline and at least 1 year of reimbursement and/or customer care experience in a medical, health insurance, or pharmacy technician role; or a high school diploma or GED and at least 4 years of such experience.
Eligible to work in the United States; work-authorization sponsorship is not offered.
Excellent verbal and written communication.
Strong organization skills.
Ability to use multiple systems simultaneously and thrive in a fast-paced, high-volume environment.
Ability to empathize, prioritize, and maintain flexibility.

Nice To Haves

Experience with Salesforce or SFDC.
Proficiency with Microsoft Suite.
Data entry experience.
A collaborative mindset and enjoyment of working in a team environment.
Customer-centric mentality.
Bilingual English/Spanish.

Responsibilities

Provide prompt, professional phone assistance to patients, caregivers, and providers regarding specialty medication enrollment, access barriers, and affordability solutions, targeting first-call resolution.
Guide stakeholders through benefit investigations, prior authorizations, appeals, copay assistance, and financial aid programs to clarify coverage and out-of-pocket costs.
Serve as a primary contact for complex reimbursement challenges and conduct root-cause analysis to develop solution-focused resolutions.
Collaborate with insurance verification vendors, internal partners, and cross-functional teams to streamline workflows and maintain operational alignment.
Comply with HIPAA, regulatory mandates, and program protocols; thoroughly document case interactions, patient data, and coverage updates.
Provide informal mentorship, procedural guidance, and best practices to Patient Support Specialists on complex workflows.
Identify operational bottlenecks from frontline trends and propose solutions and feedback to improve service quality.
Assist leadership with reviewing case handling, monitoring team performance metrics, and maintaining service consistency and compliance.
Communicate performance updates, operational changes, and strategic improvement areas between frontline staff and management.
Partner across organizational levels with cultural competence and foster an inclusive, patient-first team environment.