Patient Access Specialist

RXinsider LTD.; Orlando (FL); Hybrid; USD 28,000 - 36,000; Full time

Job summary

RXinsider LTD. in Orlando, FL seeks a Patient Access Specialist to process applications, introduce assistance programs, and perform benefit investigations for patients.

You will gather patient data, verify insurance benefits, contact insurers, and navigate reimbursement issues while coordinating with healthcare providers.

Qualifications

• AA or equivalent from a two-year college or technical school, or 6 months to 1 year related experience 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.

Responsibilities

• 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.

Skills

Benefit investigation

Healthcare provider communication

Call center experience

Pharmacy background

Education

Associate degree (AA) or equivalent

Tools

Microsoft Office Suite

Job description

Overview

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.

Responsibilities

• 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.

Qualifications

• 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.

Pay Range

USD $20.63 - USD $25.78 /Hr.