Improving Patient Access to Medications

2 weeks ago

Maitland, New South Wales, Australia beBeePatientAccess Full time $79,572 - $121,052
Job Title: Patient Access Specialist

This role involves collaborating directly with healthcare providers and 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 provide support to healthcare providers in addressing questions regarding coding and billing, as well as navigating complex reimbursement issues. This position also entails providing support for Prior Authorizations (PA) for an assigned caseload and helping navigate the appeals process to access medications.

Key Responsibilities:

  • Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures;
  • Conduct benefit investigations for patients by making outbound phone calls to payers to verify patient insurance benefit information, navigate complex reimbursement barriers, and seek resources to overcome the barriers;
  • Verify patient-specific benefits and document specifics including coverage, cost share, and access/provider options;
  • Identify any coverage restrictions and details on how to expedite patient access;
  • Document and initiate prior authorization processes and claims appeals;
  • Report any reimbursement trends or delays in coverage to management;
  • Act as a liaison for field representatives, healthcare providers, and patients;

Required Skills and Qualifications:

  • Benefit Investigation Experience: 2-3 years of experience involving the analysis and interpretation of insurance coverage;
  • Healthcare Provider Interaction: 2-3 years of experience interacting with healthcare providers regarding health insurance plan requirements;
  • Communication Skills: Excellent verbal communication skills and grammar;
  • Salesforce System Experience: Preferred experience with Salesforce systems.

Benefits:

  • Impactful Work: Join a team at the forefront of revolutionizing healthcare by improving patient access to essential medications;
  • Career Growth: Prioritize a

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