Patient Access Specialist

AssistRx, Inc.; United States; On-site; USD 28,000 - 36,000; Full time

Job summary

AssistRx, Inc. is seeking a Patient Access Specialist in the United States to process applications and introduce assistance programs. The role involves benefit investigation, entering patient data, and guiding patients through reimbursement issues while coordinating with insurers and healthcare providers.

Responsibilities include handling inquiries, gathering data, and following up with pharmacies, with a focus on overcoming barriers to access and reporting any adverse events as required.

Qualifications

• AA degree or equivalent from a two-year college or technical school, or six months to one-year related experience.
• MS Office skills including Word/Excel/Outlook.
• Experience in benefit investigation preferred (2–4 years).
• Experience interacting with healthcare providers about health plan requirements preferred.
• Pharmacy, call center, health insurance, or MD office background preferred.
• Exposure to enrollment, pre-assessment & benefits processes preferred.

Responsibilities

• Answers inbound calls and makes outbound calls to introduce services.
• Gathers patient data and reviews insurance benefits.
• Records call details in the patient data system.
• Contacts insurers for verification of benefits.
• Handles difficult patient situations.
• Performs follow-up with pharmacies.
• Identifies and reports adverse events per program requirements.

Skills

Benefit investigation

Provider communications

Call center experience

Healthcare payer rules

Enrollment processes

Pharmacy background

Education

AA degree 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/callcenter/health insurance or MD office experience preferred.
• Exposure to enrollment, pre-assessment & benefits' processes preferred.
• PartD claim experience preferred.

Pay Range

USD $20.63 - USD $25.78 /Hr.