Rare Disease Patient Care Coordinator

Overview

Location:

Gilbert, AZ Onsite / Remote / Hybrid options available.

Reports To:

Coverage & Access Manager. Compensation Plan: $25-27+/hr plus health benefits package, 401k plan, professional development and more.

About the Role:

A growing national specialty pharmacy organization is seeking a Coverage & Access Coordinator to support patients living with rare diseases. This role is critical in helping patients obtain life-changing medications by navigating insurance benefits, prior authorizations, and financial assistance programs. If you have experience in specialty pharmacy reimbursement, benefit investigations, or prior authorization processing and want to make a meaningful impact, this is an excellent opportunity to join a mission-driven, patient-focused team.

• Conduct detailed rare disease insurance benefit investigations to determine coverage, copays, and patient responsibility
• Process and adjudicate prescription claims, resolving rejections and coverage issues
• Prepare and submit prior authorizations and appeals, following up to ensure timely approvals
• Partner with patients, providers, and payers to overcome access barriers
• Identify and coordinate financial assistance options (copay cards, foundations, PAPs)
• Communicate claim status updates clearly to patients and healthcare teams
• Maintain accurate documentation of benefits, interactions, and resolutions
• Stay current on insurance policies, formularies, and reimbursement requirements
• Collaborate with pharmacists, patient care teams, and internal stakeholders to ensure seamless service

• High school diploma or equivalent
• Must be 18 years of age or older
• 2+ years of experience in one or more of the following:
  Pharmacy benefit investigation;
  Prior authorization processing;
  Reimbursement support;
  Specialty pharmacy or healthcare access services
• Solid understanding of:
  Insurance plans and Pharmacy Benefit Managers (PBMs);
  Medical vs. pharmacy benefit structures;
  Claim adjudication and appeals processes
• Strong attention to detail and problem-solving skills
• Excellent communication and customer service abilities
• Proficiency with computers and basic office software

• Experience supporting rare disease or specialty medications
• Knowledge of Medicare, Medicaid, and commercial insurance policies
• Familiarity with electronic prior authorization (ePA) platforms
• Certified Pharmacy Technician (CPhT)
• Bilingual language skills

• Daily use of phone systems, computers, and pharmacy software
• Microsoft Office (Word, Excel) and related applications
• Fast-paced, patient-focused specialty pharmacy workflow