Patient Access Specialist
New
Based in the United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 1–2+ years
- Required Skills
- HIPAA
Requirements
- High school diploma required; Associate’s or Bachelor’s degree preferred.
- 1–2+ 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.
Responsibilities
- 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.
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