Patient Access Specialists - Reimbursements
The purpose of this position is to process applications, introduce the assistance program, conduct benefits investigation for patients, address questions regarding coding and billing guidelines, and navigate complex reimbursement issues. This includes 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. The Case Administrator is also responsible for leading and participating in pilots, new initiatives, special projects, and cross functional teams.
- Answer inbound calls and make outbound calls to introduce services, gather patient data, address the needs of the patient and review insurance benefits. Record the call details in patient data system.
- Contact insurers for verification of benefits, coordinate prior authorizations and appeals with healthcare provider, and create reference guides.
- Collaborate with field team to maximize access to products and minimize associated administrative barriers.
- Handle difficult patient situations when they arise.
- 3 to 5 years of benefit investigation involving the analysis and interpretation of insurance coverage
- 3 to 5 years of experience interacting with healthcare providers in regards to health insurance plan requirement
- Pharmacy background/call center or MD office experience preferred
- Exposure to enrollment, pre-assessment & benefits' processes
- Excellent verbal communication skills and grammar
- Computer literacy/ competence
- Part D claim experience
- Appeal experience is a huge plus
- Supportive, progressive, fast-paced environment
- Competitive pay structure
- Matching 401(k) with immediate vesting
- Medical, dental, vision, life, & short-term disability insurance
AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.
All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.
AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire