Senior Patient Access & Reimbursement Specialist

Merck; United States; À distance; USD 45 000 - 69 000; Plein temps

Avantages offerts par ce poste

Health insurance

Paid time off

Retirement contributions

Other perquisites

Résumé du poste

Merck in the United States is seeking a Patient Support Specialist to facilitate access to prescribed therapies. You will provide patient, caregiver, and provider support with benefits verification, prior authorizations, and appeals, while guiding insurance coverage and financial assistance options.

The role emphasizes collaboration with internal teams to improve service delivery, resolve reimbursement challenges, and maintain HIPAA compliance.

Qualifications

• Diploma and 1+ year of reimbursement, pharmacy technician, and/or customer care experience in the medical or health insurance field.
• OR High School Diploma OR GED with 4+ years of reimbursement, pharmacy technician, and/or customer care experience in the medical or health insurance field.

Responsabilités

• Deliver high-touch phone support to patients, caregivers, and providers on specialty medication access, benefits verification, prior authorizations, and appeals.
• Guide patients through insurance reimbursement, copay cards, and financial assistance programs to eliminate affordability barriers.
• Investigate coverage and document case activities in compliance with program guidelines, HIPAA regulations, and First Call Resolution targets.
• Resolve complex reimbursement challenges using root cause analysis and solutions-focused thinking.
• Support PSS peers as a subject matter expert and mentor on access workflows.
• Identify inefficiencies and propose preemptive solutions to streamline reimbursement processes and enhance patient care.
• Monitor team performance and manage escalations with leadership.
• Bridge communication between leadership and PSS team by reporting KPIs and aligning strategy.

Connaissances

Customer service

Phone support

Healthcare reimbursement

HIPAA compliance

Clear communication

Formation

Diploma or GED

Outils

Salesforce

Microsoft Office

Description du poste

Merck in the United States is seeking a Patient Support Specialist to facilitate access to prescribed therapies. You will provide patient, caregiver, and provider support with benefits verification, prior authorizations, and appeals, while guiding insurance coverage and financial assistance options.

The role emphasizes collaboration with internal teams to improve service delivery, resolve reimbursement challenges, and maintain HIPAA compliance.