Patient Access Specialist

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 of benefits.
• 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.

• 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.
• 2 to 4 years of benefit investigation involving the analysis and interpretation of insurance coverage preferred.
• 2 to 4 years of experience interacting with healthcare providers regarding health insurance plan requirements preferred.
• Pharmacy background/call center/health insurance or MD office experience preferred.
• Exposure to enrollment, pre-assessment & benefits' processes preferred.
• Part D claim experience preferred.