Patient Access Specialist

Patient Access Specialist, Rare/Orphan

At Biologics by McKesson, our mission is to simplify access to medication and deliver personalized care that helps patients achieve the best-possible outcomes one patient, one partner, one therapy at a time.

The Patient Access Specialist, Rare/Orphan will be responsible for benefits investigation, prior authorization support, and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures.

Compensation: The target budget for this role is between $24 and $25 an hour with a 5% bonus.

Location: This is a hybrid role. Candidate will be required to in office two times a week and must live within a drivable distance of our Cary, NC location.

Key Responsibilities

• Locate and enter accurate prescription insurance information on patient's profile by processing eligibility checks and adjudicating pharmacy claims.
• Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patient
• Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process.
• Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support options
• Serve as a technical resource pertaining to adjudication while identifying areas for improvement.
• Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
• Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner
• Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan
• Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient's safety
• Perform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.)

Minimum Requirement

Typically requires 3+ years of related experience.

Education: High school diploma required

Certification: CPhT (Certified Pharmacy Technician) preferred, not required. Must be current, without restrictions, and in good standing

Critical Skills

• 3+ years prior experience working in a pharmacy or other health care setting required
• Experience with insurance eligibility and prior authorization processes
• Competent in basic computer skills and proficiency in Microsoft applications
• Conscientious, detail oriented with the ability and desire to solve problems to help our patients
• Flexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goal
• Highly motivated and committed to excellence with a positive attitude