Patient Access Specialist

SSVC is building the best team in the marketplace by investing in their associates, finding the best talent, and offering very competitive compensation.

At Sunflower State Vital Care we engage with patients, customers and colleagues in the following ways:

- At SSVC Kindness is our foundation. We treat everyone with friendliness, generosity, consideration and empathy.

- Each day, each endeavor at SSVC is filled with Enthusiasm! We always have a smile, are eager to please, have passion about what we do and approach interactions with energy.

- We take an honest, principled and forthright approach with an emphasis on being consistent, fair and transparent…we have Integrity.

- Professionalism is paramount at SSVC. We aim to be competent, skilled and knowledgeable. Most of all, we provide expertise in both patient care and customer service and hold our organization to high standards.

At SSVC we work with a passion to help patients achieve their goals by providing the best patient care in an environment that is fun, adaptive, and made to help provide exceptional service. The ideal candidate should have experience with communicating with patients and other health care professionals. They will be responsible for working with orders and following them through from start to finish. You will also be trained, if you already do not have experience, in compounding sterile preparations and all of the requirements needed. This position reports to the pharmacy manager.

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 and payors 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
- Document and initiate prior authorization process and claims appeals
- 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
RequirementsEducation required:
- High School Diploma Education preferred:
- 3 to 5 years of benefit investigation involving the analysis and interpretation of insurance coverage preferred
- 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
Specific type of experience preferred:
- 2 to 3 years of claims, health insurance benefits or health care billing experience.
- Pharmacy technician certification required, assistance with application will be provided if needed.

Job Type: Full-time

Pay: $18.00 - $25.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Health insurance
• Paid time off
• Professional development assistance
• Referral program
• Relocation assistance

Schedule:

• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Pharmacy technician experience: 1 year (Preferred)

Ability to Relocate:

• Topeka, KS 66615: Relocate before starting work (Required)

Work Location: In person

Salary : $18 - $25