Patient Services Representative

Employee Relations Associates, Inc.; Fort Mill, Northern (SC, KY); Hybrid; USD 40.000 - 60.000; Vollzeit

Zusammenfassung

TalentBridge is partnering with a leading healthcare services organization to hire a Patient Services Representative focused on specialty pharmacy access and reimbursement support. This role centers on helping patients navigate insurance coverage, enrollment, and assistance programs.

Ideal candidates bring healthcare customer service experience, benefits verification, and familiarity with prior authorizations and Medicare/Medicaid plans.

Qualifikationen

• High school diploma or GED; bachelor's degree preferred.
• Experience in healthcare customer service or related field strongly preferred.
• Knowledge of specialty pharmacy, patient support programs, or reimbursement is a plus.

Aufgaben

• Serve as a primary contact for patients, providers, pharmacies, and caregivers for specialty access and support.
• Assist with enrollment, insurance verification, benefits investigations, and patient assistance program eligibility.
• Respond to inquiries about coverage, status, and next steps.
• Coordinate with providers and pharmacies to obtain missing information and prior authorization requirements.
• Research and resolve insurance claim denials and reimbursement issues.
• Maintain accurate patient records in healthcare CRM and case management systems.
• Communicate with patients and providers via phone, email, and other channels.
• Manage cases and work queues, meeting productivity and quality standards.
• Escalate complex issues and identify opportunities to improve patient experience.
• Ensure HIPAA compliance and adherence to policies.

Kenntnisse

Healthcare customer service

Benefits verification

Prior authorizations

Pharmacy knowledge

Ausbildung

High school diploma or GED

Bachelor's degree preferred

Tools

Microsoft Outlook

Excel

Healthcare CRM systems

Jobbeschreibung

Patient Services Representative – Specialty Pharmacy & Patient Access

About the Opportunity

TalentBridge is partnering with a leading healthcare services organization specializing in patient access, specialty pharmacy support, and pharmaceutical reimbursement services to hire experienced Patient Services Representatives.

This position offers an opportunity to make a meaningful difference in patients' lives by helping individuals navigate insurance coverage, access prescribed specialty medications, and overcome barriers to treatment.

The ideal candidate brings experience in healthcare customer service, benefits verification, prior authorizations, specialty pharmacy, patient assistance programs, or reimbursement support.

Key Responsibilities

Serve as a primary point of contact for patients, healthcare providers, pharmacies, and caregivers regarding specialty medication access and support programs.

Assist patients with enrollment, insurance verification, benefits investigations, and patient assistance program eligibility.

Respond to inbound calls and inquiries regarding coverage, program services, prescription status, and next steps.

Coordinate with healthcare providers and pharmacies to obtain missing information, documentation, and prior authorization requirements.

Research and resolve insurance claim denials, coverage discrepancies, and reimbursement-related issues.

Assist with copay assistance programs, manufacturer-sponsored patient support programs, and other financial assistance resources.

Maintain accurate patient records and document all interactions within healthcare CRM and case management systems.

Communicate with patients and providers through phone, email, fax, and other approved communication channels.

Manage assigned cases and work queues while meeting established productivity, accuracy, and quality standards.

Escalate complex issues and identify opportunities to improve the patient experience.

Ensure compliance with HIPAA regulations, company policies, and program-specific procedures.

Qualifications

High school diploma or GED required; bachelor's degree preferred.

Minimum of 3 years of experience in healthcare customer service, patient services, medical billing, insurance verification, benefits investigation, or a related healthcare field.

Experience working with specialty pharmacy, pharmaceutical patient support programs, or healthcare hub services strongly preferred.

Familiarity with prior authorizations, insurance claims, copay assistance, Medicare, Medicaid, and commercial insurance plans.

Strong communication skills and ability to interact professionally and compassionately with patients, providers, and caregivers.

Excellent organizational skills, attention to detail, and ability to manage multiple cases simultaneously.

Comfortable working in a high-volume, metrics-driven environment.

Proficiency with Microsoft Outlook, Word, Excel, and healthcare-related systems.

Ability to work independently while collaborating with internal teams.

Preferred Experience

Candidates with backgrounds in the following areas are strongly encouraged to apply:

• Specialty Pharmacy & Pharmaceutical Hub Services
• Patient Access & Patient Support Programs
• Benefits Verification & Benefits Investigation
• Prior Authorization & Insurance Verification
• Reimbursement Services & Claims Resolution
• Copay Assistance & Patient Assistance Programs
• Healthcare Call Centers & Case Management

Why This Opportunity?

Join a patient-focused healthcare organization where your work directly supports individuals navigating complex insurance and specialty medication processes. You'll collaborate with healthcare professionals, develop your expertise in patient access and reimbursement, and help patients start and remain on critical therapies.

“ TalentBridge employees are eligible for many benefit offerings such as medical, dental, vision, life insurance, short term disability, 401(k) and holiday pay!”