Patient Access Specialist

RXinsider LTD.; Overland Park (KS); On-site; USD 32,000 - 40,000; Full time

Job summary

RXinsider LTD. seeks a Patient Access Specialist to process applications, introduce the assistance program, and navigate complex reimbursement issues. You will perform initial data entry, look up insurance benefits, contact insurers, and advise providers and patients on benefits while identifying access barriers.

The role involves pilots and cross‑functional projects, with a focus on accurate data capture, effective communication, and timely follow‑up with insurers and pharmacies.

Qualifications

• AA degree or 6 months to 1 year related experience or equivalent.
• Microsoft Office proficiency required.
• Pharmacy/call center/health insurance or MD office experience preferred.
• Exposure to enrollment, pre-assessment & benefits processes preferred.
• Part D claim experience preferred.

Responsibilities

• Answer inbound calls and make outbound calls to introduce services.
• Gather patient data and review insurance benefits.
• Record call details in patient data system.
• Contact insurers for verification of benefits.
• Handle difficult patient situations when they arise.
• Conduct follow-up with pharmacies.
• Identify and report safety information as required.

Skills

Call center experience

Benefit investigation

Healthcare provider interaction

Education

Associate degree in any field

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 Microsoft Office Suite.
• 2 to 4years of benefit investigation involving the analysis and interpretation of insurance coverage preferred.
• 2 to 4years of experience interacting with healthcare providers regarding healthinsurance plan requirements preferred.
• Pharmacy background/callcenter/health insurance or MDoffice experience preferred.
• Exposure to enrollment,pre-assessment & benefits'processes preferred.
• Part Dclaim experience preferred.

Pay Range

USD $23.11 - USD $28.89 /Hr.