Account Care Educator

RXinsider LTD.; Town of Florida (NY); On-site; USD 32,000 - 39,000; Full time

Job summary

RXinsider LTD. is seeking an Account Care Educator to support prescribers, patients and field agents within an assigned territory. You will guide next steps, coordinate with Assist resources, and ensure patient outcomes.

The role includes handling inbound calls, striving for one-call resolution, and managing Medicare and commercial reimbursement processes, including billing, claims and denials. You will report adverse events per program requirements.

Qualifications

• Strong written and verbal communication with providers, patients and insurers.
• Interpersonal skills to work with diverse publics.
• Problem solving abilities and computer literacy.

Responsibilities

• Serve as single point of contact for questions from prescriber, patient and field agent by territory.
• Identify applicable programs and facilitate next steps.
• Communicate status of all patient support activities.
• Liaise with other Assist resources to secure outcomes for active patients.
• Handle inbound calls for territory or overflow and provide one call resolution.
• Ensure reimbursement processes including billing, claims and denials.
• Identify and report adverse events and safety information.

Skills

Communication skills

Interpersonal skills

Problem solving

Computer skills

Education

College degree preferred

Tools

Billing software

Microsoft Office

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.