Patient Access Specialist 826 Start

JobDescription :

Thepurpose of this position is to help patients get access to themedications and therapies that they need. This role works withhealthcare providers patients payors and pharmacies to gatherinformation about a patient s insurance policy and the coverageprovided by that policy for a specific pharmaceutical product.

Thisposition provides access and affordability services for an assignedcaseload and helps healthcare professionals and patients navigateany challenges the patient will face to access medications.

Thework of the Patient Access Specialist helps make therapies moreaffordable for patients and gets patients on therapies faster.

Provide daytoday oversight for caseload to ensure all cases andtasks are completed in a timelymanner.

ShiftsAvailable :

MF9am6pm (1 hourlunch)

MF10am7pm (1 hourlunch)

MF11am8pm (1 hourlunch)

MF12pm9pm (1 hourlunch)

WeekendShift 9am5 : 30pm (1 hour lunch) *You must select any 2 days offduring the week which will remain consistent. Saturday &Sunday is required.

The 2 days off must be chosen at the time ofthe offeracceptance.

Training :

Day1 (8 / 26) : 9 : 30am4 : 30pm

Day 25 (8 / 278 / 30) : 8 : 30am4 : 30pm

Day 5 TBD

1 hour paid lunch breakduring training (this is an 8 hour day they don t clock out duringmealbreak)

Major duties and responsibilities that arecritical and necessary for this position and its overallobjective :

Ensure cases move through the process as required

Conductbenefit investigations for patients by making outbound phone callto payors to verify patient insurance benefit information navigatecomplex reimbursement barriers and seek resources to overcome thebarriers

Verify patient specific benefits and document specifics includingcoverage cost share and access / provider options

Identify any coverage restrictions and details on how to expeditepatient access

Document and initiate prior authorization process and claimsappeals

Report any reimbursement trends or delays in coverage to management

Assignappropriate cost sharing solutions or assess and refer the patientto any special programs / services (as appropriate)

Communicate the results of benefit investigations for patients tohealthcare providers and patients in a timely manner andaccurately

Requirements

Educationrequired : HighSchool Diploma

HighSchool Diploma

Educationpreferred :

Associate s or Bachelor s Degree in Science Finance or Business

Yearsof experience required :

3 to 5years of benefit investigation involving the analysis andinterpretation of insurance coverage

3 to 5years of experience interacting with healthcare providers inregards to health insurance plan requirement

Pharmacy background / call center or MD office experience preferred

Exposure to enrollment preassessment & benefits processes

Excellent verbal communication skills and grammar

Computer literacy / competence

Specifictype of experience preferred :

2 to 3years of claims health insurance benefits or health care billingexperience.

SalesForce systemexperience.

Years of experience required : - 3 to 5 years of benefitinvestigation involving the analysis and interpretation ofinsurance coverage - 3 to 5 years of experience interacting withhealthcare providers in regards to health insurance planrequirement - Pharmacy background / call center or MD officeexperience preferred - Exposure to enrollment, pre-assessment &benefits' processes - Excellent verbal communication skills andgrammar - Computer literacy / competence