Patient Access Specialist

Walgreens; Pennsylvania; On-site; USD 25,000 - 34,000; Full time

Job summary

Walgreens is seeking a Patient Access Specialist to manage the patient’s financial journey, including benefits investigation, prior authorizations, and enrollment in financial assistance programs. You will communicate with patients, prescribers, and payors to clarify coverage and coordinate timely processing.

The role emphasizes empathetic, patient-centered support, accurate record-keeping, and collaboration with clinical teams while ensuring compliance with HIPAA and organizational policies.

Qualifications

• High school diploma or GED or equivalent.
• At least 1 year in healthcare, specialty pharmacy, PBM or call center.
• Experience delivering customer service to internal and external customers.
• Ability to communicate clearly, written and verbal.
• Basic PC skills and familiarity with MS Office.

Responsibilities

• Verify patient coverage for pharmacy and medical benefits and explain available financial assistance.
• Initiate, complete, and track prior authorizations and appeals with providers and payors.
• Submit claims, resolve payor rejections, and address coverage discrepancies.
• Collect and submit documentation for copay cards and patient assistance and monitor renewals.
• Coordinate between patients, providers, and payors to clarify benefits and next steps.
• Maintain accurate records of interactions and program details.
• Escalate complex cases to management and address adverse events with the clinical team.
• Ensure HIPAA compliance and cross-train in other key functions.
• Participate in onboarding training and ongoing development.

Skills

Clear communication

Interpersonal skills

Basic PC skills

MS Windows / MS Office

Tools

MS Windows

MS Office

Job description

Job Summary

The Patient Access Specialist oversees the patient’s financial journey from start to finish, including benefits investigation, prior authorization support, and enrollment in financial assistance programs. This role manages inbound and outbound communication with patients, prescriber offices, and third-party providers to clarify medical and pharmacy coverage, benefits, and related inquiries, ensuring all interactions are handled efficiently and courteously. Key responsibilities include resolving complex insurance rejections that require follow-up with patients, providers, and payors; managing the full authorization process—prior authorizations, appeals, and medical tier exceptions—by initiating, reviewing, submitting, tracking, and following up on requests. The specialist coordinates enrollment in manufacturer-sponsored assistance programs and other financial support resources, serving as a liaison between patients, healthcare providers, insurance companies, and program sponsors to ensure accurate documentation and timely processing.

Job Responsibility

• Confirm patient coverage for pharmacy and medical benefits, including eligibility, co-pays, deductibles, secondary insurance, and network status. Identify and explain available financial assistance programs.
• Initiate, complete, and track prior authorizations, medical tier exceptions, and appeals. Prepare documentation, collaborate with providers and payors, and ensure adherence to timelines for approvals and denials.
• Submit accurate claims for reimbursement, resolve non-clinical payor rejections (e.g., plan limits, coverage terminations), and address benefit discrepancies between insurance providers.
• Collect and submit required documentation for copay cards, patient assistance, and other support programs. Monitor renewals, educate patients and providers on eligibility, and resolve delays or denials.
• Act as a liaison among patients, providers, and payors to clarify benefits, coverage, and next steps. Provide empathetic, patient-centered support for those navigating financial or medical challenges.
• Maintain accurate records of interactions, outcomes, and program details.
• Escalate complex cases to management or program sponsors as needed.
• Escalate all concerns of adverse events and product quality concerns to the clinical team.
• Ensure compliance with HIPAA regulations and organizational polices.
• Crosstrain and provide support in other key functions within the organization where needed.
• Participate in post-onboarding training and development as needed to enhance skills and performance.

About Walgreens

Founded in 1901, Walgreens (www.walgreens.com) proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.

Basic Qualifications

• High school diploma from an accredited school or equivalent GED.
• At least 1 year of work experience in healthcare, specialty pharmacy, PBM and/or call center settings.
• Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction in healthcare, specialty pharmacy, PBM, call center setting or other related industry.
• Ability to communicate clearly and effectively (written and verbal). Good interpersonal skills with the ability to communicate in a diplomatic and confidential manner.
• Basic level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).

Preferred Qualifications

• Experience providing customer service in a healthcare, specialty pharmacy, PBM, call center setting or other related industry including but not limited to adherence, quality, etc.
• Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
• Familiarity of medical terminology, prescriptions, and pharmacy regulations.
• Intermediate level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line)

We will consider employment of qualified applicants with arrest and conviction records.

The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled.

Salary Range: $18.25 - $24.35 / Hourly