Patient Access Specialist

Patient Access Specialist

This role plays a critical part in helping patients and healthcare providers navigate access to essential medications through reimbursement, affordability, and support programs. You will operate within a fast-paced healthcare contact center environment, serving as both a subject matter expert and team lead supporting case resolution and service quality. The position combines patient advocacy, case management, and operational oversight to ensure timely access to treatment. You will guide team members, monitor service quality, and provide feedback to improve performance and compliance. A key part of your work will involve coordinating across payers, pharmacies, and internal teams to resolve complex access barriers. This is a highly impactful role for someone passionate about healthcare equity, patient support, and operational excellence in a regulated environment.

Accountabilities:

• Lead daily operations supporting patient and healthcare provider inquiries across multiple channels, including phone, email, fax, and chat.
• Oversee case management activities to ensure accurate documentation, timely resolution, and compliance with program requirements.
• Support patients in understanding medication access pathways, including reimbursement, affordability, and assistance programs.
• Perform quality monitoring of calls and provide coaching and feedback to contact center team members.
• Serve as a subject matter expert, resolving escalations and guiding complex case investigations.
• Coordinate with payers, pharmacies, and third-party administrators to facilitate benefits investigations, prior authorizations, and appeals.
• Ensure adherence to HIPAA regulations, privacy standards, and internal compliance guidelines.
• Assist leadership with reporting, metrics tracking, and continuous improvement initiatives.

Requirements:

• High school diploma required; Associate's or Bachelor's degree preferred.
• 12+ years of healthcare, patient support, or insurance reimbursement experience.
• Strong understanding of health insurance processes, pharmacy benefits, and Rx reimbursement pathways.
• Knowledge of HIPAA regulations and commitment to maintaining strict patient confidentiality.
• Experience in contact center or case management environments strongly preferred.
• Excellent communication skills, both written and verbal, with strong interpersonal abilities.
• Strong attention to detail, organizational skills, and ability to manage multiple priorities.
• Ability to work collaboratively in a fast-paced, dynamic, and compliance-driven environment.
• Problem-solving mindset with empathy, adaptability, and a sense of urgency.

Benefits:

• Competitive compensation package
• Comprehensive health benefits including medical, dental, and vision coverage
• 401(k) retirement savings plan
• Paid time off, maternity and paternity leave benefits
• Disability and life insurance coverage
• Employee discounts and recognition programs
• Career development opportunities within a healthcare-focused organization
• Collaborative, mission-driven work environment recognized as a Great Place to Work.