Patient Access Specialist

• This position will be responsible for addressing:
  • All cases including complex reimbursement issues.
  • Providing education and information relating to the utilization of available resources to support appropriate patient access to therapies.
  • Working patient cases that come through the Access 360 program.
• This role will focus on identification of access issues and excellent and responsive support providing information and resources to address reimbursement access barriers and maintaining strong internal and external communications.

Key Roles/ Responsibilities:

• Manage day to day activities of health care provider support request and deliverables.
• 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 with Access 360 PAA staff.
• Serve as a single point of contact 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.
• Educate offices on Access 360 programs and referral process to ensure timely case processing.

Qualifications/ Requirements:

• Associates Degree or equivalent education in health sciences, managed healthcare, public policy, social work or related disciplines.
• Minimum 2 years of 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.
• Business travel, by air or car, is required for regular internal and external business meetings.
• Ability to work specific shift hours.

Preferred:

• Bachelor's degree, RN, BSN, or equivalent education in health sciences, managed healthcare, public policy, social work or related disciplines.
• Minimum 3 years of healthcare/healthcare reimbursement experience; high level of proficiency in all aspects of reimbursement and access, i.e., benefit investigations, specialty pharmacy distribution, private.
• Public payer reimbursement policies and procedures, regulatory and administrative rules.
• Relevant biologics healthcare/insurance experience.
• Billing/Coding background in buy and bill and Specialty Pharmacy markets.
• Ability to drive projects and cases to completion, be self-directed, have excellent verbal and written communication skills.
• Analytical thinking, problem solving and decision making.
• Effective organizational management.
• Proficient competency using Word, Excel and PowerPoint.
• Ability to multitask and manage multiple parallel projects.
• Business acumen; knowledgeable in current and possible future policies, practices, trends, technology and information affecting Access Services programs.

All your information will be kept confidential according to EEO guidelines.