Patient Access Specialist

Job Description

Job Description

Position: Benefit Investigation Specialist (Patient Access Specialist)

Must Haves:

• HS Diploma or GED
• Computer Skills: Microsoft Office
• 2+ years of medical benefit investigation experience- buy and bill experience
• Experience working with and explaining insurance coverage
• Experience working w all the major payors (UHC, BCBS, Medicare/caid, Aetna, etc.)
• Experience making outbound calls 

Plus:

• Call Center Experience
• Pharmacy Experience
• Salesforce Experience 

Day to Day

The Patient Access Specialist is responsible for processing applications, introducing the assistance program, conducting benefit investigation for patients, and navigating complex reimbursement issues including initial entry of patient data into the system, looking up insurance benefits, contacting insurers, advising the healthcare provider and/or patient of patients’ benefits, and identifying patient access barriers and seeking resources to overcome barriers; leading and participating in pilots, new initiatives, special projects, and cross functional teams.

• Answers inbound calls and makes outbound calls to introduce services.
• Gathers patient data, addresses the needs of the patient and reviews insurance benefits.
• Records the call details in patient data system.
• Contacts insurers for verification of benefits.
• Handles difficult patient situations when they arise.
• Conducts follow-up with pharmacies.
• Performs other related duties as assigned by management.