Patient Access Specialist

RXinsider LTD.; Cary (NC); Hybrid; USD 32,000 - 33,000; Full time

Job summary

McKesson is seeking a Patient Access Specialist, Rare/Orphan, to manage benefits investigation, prior authorization support, and claims adjudication. The hybrid role requires two in-office days weekly at our Cary, NC location.

The position emphasizes accurate data entry, patient communication, and timely delivery coordination. The ideal candidate has 1+ year of related experience, familiarity with insurance processes, and a Customer-first mindset.

Qualifications

• Minimum 1 year of related experience in pharmacy or healthcare setting.
• Experience with insurance eligibility and prior authorization processes.
• Proficient with basic computer skills and Microsoft Office applications.
• Detail-oriented and conscientious with problem-solving mindset.
• Strong interpersonal and communication skills; empathetic with patients and caregivers.
• Ability to work in a team and adapt to a fast-paced environment.

Responsibilities

• Locate and enter accurate prescription insurance information by processing eligibility checks and adjudicating claims.
• Adjudicate claims and troubleshoot rejections to ensure correct information is communicated to patients.
• Communicate the need for medication prior authorization (PA) to providers and support PA processes.
• Handle inbound calls from patients and providers regarding order status, services, and financial support options.
• Serve as a technical resource on adjudication and identify areas for improvement.
• Enter detailed, accurate progress notes to maintain proper patient profiles.
• Contact patients to schedule medication delivery and ensure profile data is up to date.
• Coordinate patient refills and follow up to support adherence to therapy.

Skills

Attention to detail

Empathy and patient service

Communication skills

HIPAA compliance

Teamwork

Education

High school diploma

CPhT (Certified Pharmacy Technician)

Tools

Microsoft Office

Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

Mission

At Biologics by McKesson, our mission is to simplify access to medication and deliver personalized care that helps patients achieve the best-possible outcomes — one patient, one partner, one therapy at time.

Purpose

The Patient Access Specialist, Rare/Orphan will be responsible for benefits investigation, prior authorization support, and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures.

Compensation

The target rate for this is between $23 and $24 an hour along with a 5% bonus.

Location

This is a hybrid role and will require two days a week in office at our Cary, NC location.

Key Responsibilities

• Locate and enter accurate prescription insurance information on patient’s profile by processing eligibility checks and adjudicating pharmacy claims.
• Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patient
• Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process.
• Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support options
• Serve as a technical resource pertaining to adjudication while identifying areas for improvement.
• Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
• Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner
• Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan
• Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient’s safety
• Perform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.)

Minimum Requirement

Typically requires 1+ years of related experience.

Education & Certification

• CPhT (Certified Pharmacy Technician) preferred, not required. Must be current, without restrictions, and in good standing
• High school diploma required

Critical Skills

• 1+ years prior experience working in a pharmacy or other health care setting required
• Experience with insurance eligibility and prior authorization processes
• Competent in basic computer skills and proficiency in Microsoft applications
• Conscientious, detail oriented with the ability and desire to solve problems to help our patients
• Flexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goal
• Highly motivated and committed to excellence with a positive attitude

Additional Skills

• Strong interpersonal and communication skills; able to engage empathetically with patients and caregivers.
• Understanding of HIPAA, patient privacy, and compliance regulations.
• Strong prioritization and time management skills
• Proficiency in quickly and thoroughly understanding patient and provider needs
• Demonstrated ability to communicate complex concepts with high efficacy

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered.

Our Base Pay Range for this position

$15.93 - $26.55

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category.

For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) [e-mail] or (Canada) [e-mail]. Resumes or CVs submitted to this email box will not be accepted.

Join us at McKesson!