Job Details

Description

Ideal Candidate Profile: 

• Bachelor’s degree OR four years of related work experience 
• Customer Service experience/understanding - 1 to 3 yrs (Environments Like: Call center, Dr's Office, Medical Billing Office) 
• Reimbursement experience in HUB environment - 1-3 yrs 
• Excellent communication skills (verbal/written) 
• Basic Word (must score 70% or higher to be considered)

Key Roles/ Responsibilities: 

• Manage day to day activities of health care provider support requests and deliverables across multiple communication channels i.e. Phone, Fax, Chat, eMail, etc. 
• Perform intake of cases and capture all relevant information in the Access 360 Case Management system 
• Ensure all support requested is captured within the Case Management system 
• Ensure timely processing and resolution of cases 
• Escalate cases appropriately to the Patient Access Associate team 
• Coordinate all appropriate aspects of patient case management through to completion, using effective interpersonal skills to manage interactions 
• Serve as a resource for Health Care Providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for complex patient access situations, working closely with the PAA team to appropriately escalate/resolve issues 
• Communicate effectively with payers, third party administrators and other departments 
• Perform in-depth research into patient’s insurance, prior authorization and appeal requests on behalf of the provider 
  
  

Minimum Requirements: 

• Associates Degree or equivalent education in health sciences, managed healthcare, public policy, social work or related disciplines 
• Minimum 2 years of healthcare/healthcare reimbursement experience; high level of proficiency in all aspects of reimbursement and access, i.e., benefit investigations, specialty pharmacy distribution, private and public payer reimbursement policies and procedures, regulatory and administrative rules 
• Coordination of patient access experience 
• Expert knowledge of specialty products, reimbursement for medical and pharmacy benefits, patient access processes and patient assistance programs: operational policies and processes 
• Proven track record for consistently meeting or exceeding qualitative, as well as any relevant quantitative, targets and goals 
• Experience with HIPAA policy, patient access data and analytics 
• Must be able to support all hours of operations (Hours of operations are 8am-8pm ET) 

Questions

The Patient Access Specialist role provides support across 3 regions; therefore scheduling may vary.  Are you able to work until 8pm EST?

Do you have any scheduled vacation and/or time off in the next 90 days?  If so, when?