Healthcare Insurance Coordinator

6 days ago

Sydney, New South Wales, Australia beBeeAccess Full time $70,000 - $95,000

As a key member of our team, the Patient Access Specialist will play a vital role in ensuring seamless communication between healthcare providers and insurance payers.

This critical position involves gathering information about patient insurance coverage and navigating complex reimbursement issues to ensure timely access to medications.

The specialist will provide dedicated support for Prior Authorizations (PA) and help facilitate the appeals process to resolve any barriers to medication access.

Key Responsibilities:

  • Ensure all cases are processed efficiently and compliantly with company standards and procedures.
  • Conduct thorough benefit investigations by making outbound calls to verify patient-specific benefits, navigate reimbursement barriers, and identify resources to overcome these challenges.
  • Verify coverage, cost share, and access/provider options for patients.
  • Identify coverage restrictions and explore solutions to expedite patient access.
  • Document and initiate prior authorization processes and claims appeals.
  • Report reimbursement trends or delays to management.
  • Act as a liaison between field representatives, healthcare providers, and patients.
  • Demonstrate expertise in Major Medical & Pharmacy Benefit Coverage.
  • Possess 2-3 years of experience in benefit investigation involving insurance coverage analysis and interpretation.
  • Have 2-3 years of experience interacting with healthcare providers regarding health insurance requirements.
  • Exhibit exceptional verbal communication skills and grammar.
  • Experience with Salesforce system is preferred.

Essential Competencies:

  • Adaptability, Punctuality, Customer Service, Ethics, Interpersonal Skills, Oral Communication, Organizational Support, Professionalism, Quality, Teamwork.

Our organization prioritizes creating a positive work environment where talented professionals thrive. We recognize the value of dedicated employees and strive to maintain an inclusive atmosphere that fosters personal and professional growth.

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