Patient Access Specialist (Inbound)

Doist; Plano (TX); On-site; USD 28,000 - 36,000; Full time

Benefits offered by this job

Competitive pay - $23 per hour

Wellness benefits

Paid Time Off

Paid Holidays

Parental Leave Benefits

401(k) Retirement Savings Program

Short-term and long-term disability

Commuter Benefits

Employee Assistance Program (EAP)

Professional development and training

Job summary

SmithRx in Plano, TX is seeking an Inbound Patient Access Specialist to guide members through accessing medications cost-effectively. You will handle inbound communications, enroll members in drug savings programs, and deliver world-class customer service with a one-call resolution approach.

You will coordinate with providers, pharmacies, and manufacturers, maintain HIPAA-compliant records, and meet performance metrics while staying up-to-date on PBM processes.

Qualifications

• High School diploma or GED or equivalent required.
• 2+ years of experience in healthcare call center environments handling inbound calls.
• Local candidates only.
• Proficiency in Windows, MS Office, and G-Suite required.
• Experience with Salesforce preferred.
• Knowledge of PBM systems and health insurance processes preferred.
• Knowledge of health insurance plans and medication reimbursement processes preferred.
• Excellent verbal and written communication and empathetic customer service.

Responsibilities

• Educate patient members about their pharmacy benefits and help them source medications they need through various programs.
• Provide support to/assist members, providers and pharmacies via inbound phone calls, email, and other appropriate channels.
• Handle inbound calls pertaining to enrollment in drug savings programs and resolve inquiries.
• Coordinate with members, physicians, drug manufacturers, and pharmacies to facilitate enrollment in savings programs.
• Maintain documentation, ensure HIPAA compliance, and strive for one-call resolutions.

Skills

Local residency

Inbound call handling

Outbound call experience

Windows

MS Office

G-Suite

Salesforce

PBM knowledge

Health insurance knowledge

Communication skills

Active listening

Multitasking

Time management

Problem solving

Adaptability

Critical thinking

Education

High School diploma or GED

Tools

Windows

MS Office

G-Suite

Salesforce

Job description

Who We Are

Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service. With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country. We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values: Integrity: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new. Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always. Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

Job Summary

As an Inbound Patient Access Specialist, you will advocate for patient members by guiding them through the complexities of obtaining medications efficiently and cost-effectively. You will manage inbound communications to ensure members receive timely enrollment in drug savings programs and experience world-class customer service regarding their pharmacy benefits by providing a one-call resolution.

What you will do

Educate patient members about their pharmacy benefits and help them source medications they need through various programs. Provide support to/assist members, providers and pharmacies via inbound phone calls, email, and other appropriate communication channels. Handle inbound calls pertaining to enrollment in drug savings programs and resolve their inquiries. This role’s success metrics include providing one-call resolution to members, providers, and pharmacies . This role will gather any missing necessary information to successfully resolve the case, with emphasis on a one-call resolution approach. This role requires good understanding of all Patient Access savings programs . Coordinate with members, physicians, drug manufacturers, and pharmacies to facilitate enrollment in savings programs. Manage every call by accurately resolving the issue, demonstrating compassion, meeting compliance requirements, and ensuring a hassle-free experience for our Members. Provide empathetic support to patients by phone, email, and other channels. Maintain impeccable documentation, responsiveness, timeless of response with follow-up of each member call. Have a patient-centric mindset and a high sense of urgency to solve requests. Work with sensitive information while upholding PHI and HIPAA standards. Stay updated on organizational processes and policies to maintain compliance and ensure service quality. Organize case details per required standards and keep track of multiple tasks to ensure optimal productivity in a fast paced environment. Achieve or exceed specific key performance indicators and meet service level expectations to maintain high-quality service standards. Consistently maintain quality assurance standards and strict adherence to schedule, contributing to the overall efficiency and reliability of support.

What You Will Bring To SmithRx

• Candidates must be locally based.
• Potential to work from home four days per week based on performance, after 60 days of onsite onboarding.
• Requires 100% attendance during training period.
• High School diploma or GED or equivalent required.
• 2+ years of experience in healthcare call center environments handling inbound call is required.
• Outbound call experience is preferred.
• Proficiency in Windows, MS Office, G-Suite required.
• Salesforce experience preferred.
• Knowledge and understanding of pharmacy benefits manager (PBM) systems and processes is preferred.
• Knowledge of health insurance plans and medication reimbursement processes is preferred.
• Understanding of drug savings programs and patient assistance programs is preferred.
• Exceptional verbal and written communication skills.
• Demonstrated professionalism, active listening, and empathetic conversational skills.
• Ability to multitask, prioritize effectively, and manage time efficiently.
• Ability to quickly identify issues, determine the best course of action, and resourcefully find solutions to complex problems.
• Ability to learn and adapt to new technologies and processes quickly.
• Critical thinking skills with the capability to navigate through ambiguity and adapt to change.

What SmithRx Offers You

• Competitive pay - $23 per hour with opportunity for promotion and increased pay within 6+ months
• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life and AD&D Insurance
• 3 Weeks Paid Time Off
• 12 Paid Holidays
• Paid Parental Leave Benefits
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Wellness Benefits
• Commuter Benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities

Plano, TX Pay Range

$23 — $23 USD

Compensation & Benefits Base Salary

The range listed above reflects our standard pay scale and actual pay will vary based on work location, job level, job-related knowledge, skills, and experience.

Total Rewards

In addition to base pay, this role may be eligible for bonuses, commissions, or equity.

Insurance and Other Benefits

SmithRx offers a variety of benefits to help you live well, including: time off programs, medical, dental, vision, mental health support, paid parental leave, life and disability insurance and 401(k). Individual offers are tailored to your geography, experience, skills, and education. Your recruiter can share more specific details during the hiring process. In the meantime, feel free to explore our comprehensive benefits here .