AssistRx
Patient Access Specialist - Specialty Pharmacy
AssistRx, Orlando, Florida, United States, 32801
Patient Access Specialist
This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Responsibilities include: 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 calls 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 Act as a liaison for field representatives, health care providers and patients Job Details Snapshot: Compensation: $19-22/hr Start Date: August 25th Schedule: 11-8pm EST Monday - Friday Location(s): 9400 Southpark Center Loop, Orlando, FL 32819 Hybrid Opportunity: This role transitions to a hybrid opportunity after the 120 day onsite requirement, depending on attendance, performance, etc.
This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Responsibilities include: 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 calls 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 Act as a liaison for field representatives, health care providers and patients Job Details Snapshot: Compensation: $19-22/hr Start Date: August 25th Schedule: 11-8pm EST Monday - Friday Location(s): 9400 Southpark Center Loop, Orlando, FL 32819 Hybrid Opportunity: This role transitions to a hybrid opportunity after the 120 day onsite requirement, depending on attendance, performance, etc.