Patient Access Specialist

Insight Global; Orlando (FL); On-site; USD 42,000 - 56,000; Full time

Job summary

Insight Global is seeking a Patient Access Specialist in Orlando, FL. The role focuses on benefit investigations, insurance coverage explanations, and navigating complex reimbursements for patients and providers.

Day-to-day tasks include data entry, insurer outreach for benefits verification, and supporting pilots or new initiatives within cross-functional teams, while handling inbound/outbound calls to introduce services and resolve access barriers.

Qualifications

• 2+ years of medical benefit investigation experience, buy-and-bill experience.
• Experience working with and explaining insurance coverage.
• Experience working with major payors: UHC, BCBS, Medicare/caid, etna.
• Plus: Call Center Experience.
• Plus: Pharmacy Experience.

Responsibilities

• Process applications and introduce the assistance program.
• Conduct benefit investigation for patients and navigate reimbursement issues.
• Enter patient data into the system and look up insurance benefits.
• Contact insurers and advise providers/patients of benefits.
• Identify barriers and seek resources to overcome them.
• Lead and participate in pilots, new initiatives, special projects, and cross-functional teams.
• Answers inbound calls and makes outbound calls to introduce services.
• Gather patient data, addresses the needs of the patient and reviews insurance benefits.
• Record 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.

Skills

Medical benefit investigation

Buy-and-bill experience

Job description

2+ years of medical benefit investigation experience- buy and bill experience

Experience working with and explaining insurance coverage

Experience working w all the major payors -UHC, BCBS, Medicare/caid, etna, etc

Plus:

Call Center Experience

Pharmacy Experience

Day to Day

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.