PATIENT ACCESS (CASE MANAGER) - REMOTE

Job Description

Job Description

SENIOR COORDINATOR, PATIENT ACCESS (CASE MANAGER)

Location: Remote
Schedule: Full-Time, 40 Hours Per Week
Training Schedule: Monday–Friday, 8:00 AM – 5:00 PM CST (Mandatory Attendance Required)
Work Hours: Must be flexible to work shifts during business hours of Monday–Friday, 7:00 AM – 8:00 PM CST

POSITION OVERVIEW

We are seeking a Senior Coordinator, Patient Access (Case Manager) to support patients, healthcare providers, specialty pharmacies, and insurance carriers throughout the patient access journey. This role is responsible for managing the patient care process from benefit investigation through medication delivery while ensuring an exceptional patient experience.

The ideal candidate will possess strong customer service skills, healthcare reimbursement knowledge, and the ability to navigate complex insurance and patient support processes.

RESPONSIBILITIES

• Receive inbound and outbound calls from patients, healthcare providers, specialty pharmacies, and customers.
• Manage patient cases from benefit verification through medication delivery with a focus on timely resolution.
• Conduct insurance benefit investigations and verifications.
• Collaborate with physicians, specialty pharmacies, insurance companies, and healthcare providers to coordinate patient care.
• Assist with prior authorizations, appeals, and insurance coverage requirements.
• Educate patients regarding insurance coverage, out-of-pocket expenses, and appeal processes.
• Resolve patient and provider inquiries regarding case status and assistance programs.
• Maintain knowledge of Medicare, Medicaid, Managed Care, and Commercial insurance plans.
• Process enrollments received by phone, fax, and electronic submissions.
• Review enrollment forms and supporting documentation for completeness and accuracy.
• Enter and maintain accurate patient information within company systems.
• Provide exceptional customer service while maintaining compliance with company policies and procedures.
• Support less experienced team members by providing guidance when needed.

QUALIFICATIONS

• High School Diploma or equivalent preferred.
• 2–4 years of patient-facing, healthcare customer service, case management, or related experience preferred.
• Previous Hub Services or Patient Support Services experience preferred.
• Knowledge of Medicare Parts A, B, C, and D, Medicaid, and Commercial insurance plans preferred.
• Strong understanding of insurance verification, prior authorizations, appeals, and reimbursement processes.
• Excellent verbal and written communication skills.
• Strong problem-solving and critical-thinking abilities.
• Ability to build rapport with patients, caregivers, healthcare providers, and insurance representatives.
• Proficiency with Microsoft Office applications and data entry systems.
• Knowledge of pharmaceutical therapies, disease states, and medication adherence programs preferred.

REMOTE WORK REQUIREMENTS

• Dedicated, quiet, private, and distraction-free workspace.
• High-speed broadband internet connection (DSL, Cable, or Fiber).
• Dial-up, satellite, Wi-Fi-only, and cellular connections are not acceptable.
• Minimum download speed of 15 Mbps.
• Minimum upload speed of 5 Mbps.
• Maximum ping rate of 30ms.
• Hardwired internet connection to router required.
• Surge protector with network line protection required.
• Company-provided computer and equipment will be supplied.

WHAT YOU CAN EXPECT

• Opportunity to support patients through critical healthcare access and treatment journeys.
• Remote work environment with company-provided equipment.
• Exposure to specialty pharmaceuticals, reimbursement programs, and patient support services.
• Collaborative team environment with opportunities to develop healthcare industry expertise.

If you are interested, please reach out to Chin Yang at A-Line Staffing.