Patient Access Representative

Summary

Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications, with competitive compensation, preloaded PTO, and opportunities for career growth and development.

Requirements

• In-depth understanding and experience with Buy & Bill, Major Medical & Pharmacy Benefit Coverage
• 2 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 regard to health insurance plan requirements
• Excellent verbal communication skills and grammar
• Computer literacy/competence

Responsibilities

• Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
• Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
• Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
• Identify any coverage restrictions and details on how to expedite patient access
• Document and initiate prior authorization process and claims appeals
• Report any reimbursement trends or delays in coverage to management

Benefits

• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance