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Patient Access Specialist

Overland Park, KS

Posted: 01/23/2023 Division: Life Sciences Job Number: JN -012023-16296

Job Description

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

Industry: Specialty Pharmacy Care

Shifts available: 7am - 3:30pm, 8:30a - 5pm, 10:30a - 7pm

Pay: $19.00/hr. paid weekly with benefits options

Type: Temp to Permanent Hire


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.

  • Prescreens patients to determine eligibility into patient assistance programs.
  • Processes enrollment applications for patient assistance programs.
  • 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 call 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

Requirements:

High School Diploma or GED

2 to 5 years of benefit investigation, involving the analysis and interpretation of insurance coverage

3-5 years interacting with healthcare providers in regard to health insurance plan requirements

Prior authorization experience preferred

Excellent verbal communication skills and grammar skills

Computer literacy/competence

Salesforce system experience - preferred

EOE/AOE

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