Patient Access Specialist

**** WE ARE HIRING FOR BOTH ROLES ********Patient Access and Customer Service RepThis role works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations(PA) for an assigned caseload and helps navigate the appeals process to access medications.Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and qualityConduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriersVerify patient specific benefits and document specifics including coverage, cost share and access/provider optionsIdentify any coverage restrictions and details on how to expedite patient accessDocument and initiate prior authorization process and claims appealsReport any reimbursement trends or delays in coverage to managementAct as a liaison for field representatives, health care providers and patientsThe purpose of the Customer Service Representative (CSR) is to meet or exceed the customer’s expectations by assessing our customer’s needs, assigning priorities, and triaging the information to the appropriate resources. (Customers may include patients, medical professionals, and family members.) The CSR will be able to function in a multidisciplinary team to provide information about the services that are offered by Patient Services.Act as first point of contact with patients by carefully evaluating the purpose of the call, carefully assessing their purpose, prioritizing their handling, and triaging the calls if indicated. Maintain information regarding Patient Services initiatives and explain them to our customers when appropriate.Enroll new customers to Patient Services.Record activities in the patient database and follow up to secure services (such as product training, mailing of promotional materials, etc.) for our customers by contacting physician’s offices, pharmacies, and other external entities to ensure patient’s needs are being met.Complete various special projects as requiredJob Details Snapshot:Post-Training Schedules: 9-6pm/8-5pm AZT or 10-7pm/11-8pm ESTLocation(s): Phoenix, Arizona Onsite Requirements: Onsite availability required