Job Description

Ideal Candidate Profile: 
-Customer Service/Call Center experience in healthcare 
-Excellent communication skills (verbal/written)

Key Roles/ Responsibilities: 
Manage day to day activities of health care provider support requests and deliverables across multiple communication channels i.e. Phone, Fax, Chat, eMail, etc. 
Perform intake of cases and capture all relevant information in the Access 360 Case Management system 
Ensure all support requested is captured within the Case Management system 
Ensure timely processing and resolution of cases 
Escalate cases appropriately to the Patient Access Associate team 
Coordinate all appropriate aspects of patient case management through to completion, using effective interpersonal skills to manage interactions 
Serve as a resource for Health Care Providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for complex patient access situations, working closely with the PAA team to appropriately escalate/resolve issues 
Communicate effectively with payers, third party administrators and other departments 
Perform in-depth research into patient’s insurance, prior authorization and appeal requests on behalf of the provider 

Minimum Requirements:

 Associates Degree or equivalent education in health sciences, managed healthcare, public policy, social work or related disciplines 
 Healthcare/healthcare reimbursement experience; high level of proficiency in all aspects of reimbursement and access, i.e., benefit investigations, specialty pharmacy distribution, private and public payer reimbursement policies and procedures, regulatory and administrative rules 
Coordination of patient access experience 
Expert knowledge of specialty products, reimbursement for medical and pharmacy benefits, patient access processes and patient assistance programs: operational policies and processes 
Proven track record for consistently meeting or exceeding qualitative, as well as any relevant quantitative, targets and goals
Experience with HIPAA policy, patient access data and analytics 
Must be able to support all hours of operations (Hours of operations are 8am-8pm ET)

Questions:

1. Share an example of when you had to work collaboratively with multiple groups.  What was your role in this?  What was the outcome?
2. Briefly describe a time when you were able to solve a problem when others around you could not.
3. The Patient Access Specialist role provide support across 3 regions; therefore scheduling may vary.  Are you able to work until 8pm EST?