Patient Access Specialist

Job Description

Patient Access Specialist

Job Scope:

The purpose of this position is to help patients get access to the medications and therapies that they need. 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.

Title: Patient Access Specialist

Planned Start Date: 3/3/2025

Industry: Specialty Pharmacy Care

Work Location: Overland Park, KS (Work Onsite Required, after 90-120 days Hybrid schedule is possible)

Pay: Up to $20.00hr

Shift Options:

8:30am-5pm (30 min lunch)

9am-5:30pm (30 min lunch)

9:30am-6pm (30 min lunch)

10:30am-7pm (30 min lunch)

Training Work Hours: 3/3-4/18: 8am-4:30pm (1hr paid lunch)

Length of assignment: Temp to hire. If performance & attendance are met, perm role/ Hybrid schedule could be offered.

Preferred experience: Healthcare & insurance experience

Job Description:

The purpose of this position is to help patients get access to the medications and therapies that they need. This role works with healthcare providers, patients, payors and pharmacies to gather information about a patient s insurance policy and the coverage provided by that policy for a specific pharmaceutical product. This position provides access and affordability services for an assigned caseload and helps healthcare professionals and patients navigate any challenges the patient will face to access medications. The work of the Patient Access Specialist helps make therapies more affordable for patients and gets patients on therapies faster. Provide day-to-day oversight for caseload to ensure all cases and tasks are completed in a timely manner.

Major duties and responsibilities that are critical and necessary for this position and its overall objective:

• Ensure cases move through the process as required
• Conduct benefit investigations for patients by making outbound phone call to payors 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
• Report any reimbursement trends or delays in coverage to management
• Assign appropriate cost sharing solutions or assess and refer the patient to any special programs/services (as appropriate)
• Communicate the results of benefit investigations for patients to healthcare providers and patients in a timely manner and accurately
  
  

Job Skills Requirements:

• Data Entry
• Need customer service for overflow help with other teams
• Accuracy creating accounts and cases
• Updating information in accounts from Med Billers and Requirements:
• Strong accurate data entry skills
• Previous work experience in Specialty Pharmacy or Customer Service preferable
• Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications and key boarding skills
• Experience working with people in situations that are high-pressure and time-sensitive (either telephone or face-to-face), and that involve solving problems, making decisions, using excellent judgment and customer service skills. This can be obtained through a combination of work experience and post high school education, and need not be obtained in a traditional customer service setting
• Strong ability to multi-task and strong time management skills
• Ability to function in a high-volume, fast-paced environment
• Dependable and strong work ethic
• Ability to accept and implement feedback and coaching Specific type of experience preferred:
• Experience working with databases (CRM preferable) or a tracking system; Salesforce CRM experience
• Experience working in a health care/pharmaceutical industry environment
• Understanding of challenges associated with patients medical condition
  
  

Education and Experience Requirements:

• Minimum High School Diploma Education preferred: Associate or bachelor s degree in science, Finance, or Business Years of experience required:
• Experience working with databases (CRM preferable) or a tracking system
• Salesforce CRM experience
• Experience working in a health care/pharmaceutical industry environment
• Prior authorization (required)
  
  

SRG offers flexible staffing solutions with a national presence. We provide contract, contract-to-hire, direct hire and executive search services. SRG utilizes an innovative approach to identify and qualify talent that is unique to the Staffing industry, featuring a cutting-edge platform that allows us to rapidly and precisely match professionals to client requirements. We have a proprietary database of over one million candidates and maintain continuous contact with our qualified talent.

EOE/AOE

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