Patient Access Specialist

AssistRx has engineered the perfect blend of technology and talent to deliver best in class results. We believe that access to therapy transforms lives and is achieved through the powerful combination of our people and technology. We leverage advanced custom software, data analytics, and a patient-centered approach to transform medication management into a seamless and efficient process. ***VOTED one of Orlando's BEST PLACES TO WORK two years in a row*** ****WORK FROM HOME AVAILABLE AFTER 120 DAYS**** Job Details Snapshot Location(s): 4500 W 107th St, Overland Park, KS 66207 Work from home: The opportunity to work from home will be made available after 120 days upon goals and quotas being met at the discretion of the manager. Visit our Website: https://www.assistrx.com/ Why Choose AssistRx: Competitive Compensation: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary. Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary. Impactful Work : Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications. Flexible Culture: Many associates earn the opportunity to work from home after 120 days. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives. Career Growth: We prioritize a “promote from within mentality”. We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization. Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry. Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible. Tell your friends about us! If hired, receive a $750 referral bonus! The purpose of this position is to help patients get access to the medications and therapies that they need. This role works directly with healthcare providers & 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 support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. 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 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 Supportive, progressive, fast-paced environment Competitive pay structure Matching 401(k) with immediate vesting Medical, dental, vision, life, & short-term disability insurance AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws. All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position. AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire