Insurance Access Coordinator

1 week ago

Maitland, New South Wales, Australia beBeePharmaceutical Full time $60,000 - $90,000
Job Summary:

This role plays a crucial part in facilitating communication between healthcare providers and insurance plans to ensure seamless access to pharmaceutical products for patients.

Key Responsibilities:
  • Gather information on patient insurance and coverage for specific medications, ensuring compliance with industry standards.
  • Conduct thorough benefit investigations by making outbound calls to payers to verify patient insurance benefits, address complex reimbursement barriers, and seek solutions to overcome them.
  • Verify patient-specific benefits and document details, including coverage, cost share, and access/provider options.
  • IDentify any coverage restrictions and provide insights on how to expedite patient access.
  • Manage prior authorization processes and claims appeals, maintaining accurate documentation throughout.
  • Report reimbursement trends or delays in coverage to management, providing valuable insights for improvement.
  • Act as a liaison between field representatives, healthcare providers, and patients, fostering strong relationships and effective communication.
Requirements:
  • Deep understanding of Major Medical & Pharmacy Benefit Coverage, gained through extensive experience and analysis.
    • Minimum 2-3 years of benefit investigation experience, involving the interpretation of insurance coverage.
    • Proven track record of interacting with healthcare providers regarding health insurance plan requirements.
    • Excellent verbal communication skills and grammar, with the ability to articulate complex information effectively.
    • Experience with Salesforce system is a plus.

The ideal candidate will possess excellent interpersonal skills, with the ability to adapt to changing situations and priorities. They will be detail-oriented and organized, with a focus on delivering high-quality results and exceptional service.

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