Patient Access Specialist

Overland Park, KS

Posted: 04/30/2019 Job Number: JN -042019-10730
Patient Access Specialist:

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.
  • Title: Patient Access Specialist
  • Location: Overland Park, KS
  • Industry: Specialty Pharmacy
  • Hours: Monday-Friday; 9:00 am 5:30 pm
  • Salary: $18.00 hour paid weekly with benefits options
  • Employment Type: Long Term Contract 2 years+
Environment: This customer centric, fast paced, company uses integrated therapy specific care management from enrollment to adherence to simplify patient access outcomes in a call center environment. Isn t this the type of company you want to work for?

Job Scope:
  • Work 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
  • Provide access and affordability services for an assigned caseload and helps healthcare professionals and patients navigate any challenges the patient will face to access medications
  • Provide day-to-day oversight for caseload to ensure all cases and tasks are completed in a timely manner
  • 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
Skills Needed:
  • High School Diploma, Associate s or Bachelor s Degree
  • 3 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 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
  • 2 to 3 years of claims, health insurance benefits or health care billing experience.
  • SalesForce system experience a plus
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