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Patient Access Specialist
AssistRxPatient Access Specialist facilitating healthcare access through technology and analytics. Working directly with providers and payers to ensure medication availability and manage coverage issues.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in benefit investigations, including Buy & Bill and Major Medical & Pharmacy Benefit Coverage, while ensuring compliance with organizational standards. Proficient in navigating reimbursement barriers and effectively communicating with healthcare providers.
Highest-signal resume keywords
Benefit InvestigationBuy & BillMajor Medical CoveragePharmacy Benefit CoverageSalesforce Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Insurance Coverage AnalysisPrior Authorization ProcessClaims AppealsReimbursement Trends ReportingPatient Benefit Verification
Soft Skills
Excellent Verbal CommunicationStrong Grammar Skills
Tools & Technologies
Salesforce
Industry Keywords
Healthcare ProvidersPatient AccessCost ShareCoverage RestrictionsInsurance Benefit Information
About the role
Key responsibilities & impact- 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 quality
- Conduct 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 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 process and claims appeals
- Report any reimbursement trends or delays in coverage to management
Requirements
What you’ll need- In-depth understanding and experience with Buy & Bill, Major Medical & Pharmacy Benefit Coverage.
- 2 to 5 years of benefit investigation involving the analysis and interpretation of insurance coverage
- 3 to 5 years of experience interacting with healthcare providers in regard to health insurance plan requirements
- Excellent verbal communication skills and grammar
- Computer literacy/competence
- Salesforce system experience preferred
Benefits
Comp & perks- Supportive, progressive, fast-paced environment
- Competitive pay structure
- Matching 401(k) with immediate vesting
- Medical, dental, vision, life, & short-term disability insurance