Account Care Educator

RXinsider LTD.; Orlando (FL); Hybrid; USD 32,000 - 40,000; Full time

Job summary

RXinsider LTD. seeks an Account Care Educator to support prescribers, patients, and field agents within an assigned territory. You will identify assistance programs, guide next steps, and coordinate with Assist resources to help patients achieve outcomes.

In this role, you will handle inbound calls, aim for one-call resolution, and manage Medicare and commercial insurance reimbursement, including billing and denial resolution, while reporting adverse events as required.

Qualifications

• College degree preferred or high school diploma or equivalent combination.
• Experience in Medical Reimbursement or Customer Service.
• Submitting billing data to insurance providers and processing claims.
• Strong written and verbal communication with providers, patients and insurers.
• Proficient with Microsoft Office and email.

Responsibilities

• Single point of contact for questions from prescriber, patient and field agent by territory.
• Identify applicable programs and facilitate next steps.
• Liaise with program resources to secure patient outcomes.
• Handle inbound calls and provide resolution in the assigned territory.
• Identify and report adverse events and safety information.

Skills

Customer service

Communication skills

Problem solving

Interpersonal skills

Microsoft Office

Education

College degree preferred

Job description

Overview

The Account Care Educator (ACE) serves as a single point of contact within the Patient Solutions department, supporting prescribers, patients, and field agents across an assigned territory. This role bridges communication between patients and support programs, identifying appropriate assistance programs, guiding next steps, and coordinating with other Assist resources to help patients achieve successful outcomes. ACEs handle inbound calls, aim for one-call resolution, and manage the reimbursement process, including insurance billing, claims submission, and denial resolution for both Medicare and commercial insurance. The role also carries responsibility for identifying and reporting adverse events and safety information in accordance with program requirements.

Responsibilities

• Single point of contact for questionsandinquiriesfromtheprescriber, patient, andfield agent by territory.
• Identifies applicable programs and facilitates next steps.
• Holistically communicates the statuses of all patient support activities.
• Liaison with other program-specific Assist resources to secure outcomes for active patients.
• Accepts inbound calls for assigned territory or overflow of other territories and provides one call resolution support.
• Ensuresprotectionisinsured.
• Performs other related duties as assigned by management.
• Identify and report adverse events pursuant to program requirements.
• Identify, document, and report safety information.

Qualifications

• College degree is preferred or high school diploma or equivalent combination of education and experience.
• Other skills required
• Previous work experience in Medical Reimbursement or Customer Service.
• Submitting billing data to appropriate insurance providers
• Processing claims and resolving denial instances
• Achieving maximum reimbursement for services provided
• Completing Medicare and Commercial insurance claim submission.
• Documenting and reporting payment information.
• Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications, and keyboard skills.
• Demonstrated strong written and verbal communication skills with providers, patients and insurance companies.
• Interpersonal skills to facilitate work with a wide range of individuals and groups from culturally diverse publics.
• Problem solving skills.

Pay Range

USD $23.11 - USD $28.89 /Hr.