About the job
Position Summary: As a Patient Access Specialist at AssistRx, your mission will be to facilitate patient access to essential medications and therapies, ensuring that patients receive the care they need without unnecessary barriers.
Your Daily Responsibilities:
You will interact directly with healthcare providers and insurance organizations to collect and verify patient insurance details and coverage for specific pharmaceutical products. Your expertise will support healthcare providers by addressing inquiries related to coding, billing, and complex reimbursement challenges. Additionally, you will manage an assigned caseload to assist with the Prior Authorization (PA) process and navigate appeals to secure medication access.
- Ensure the timely progression of cases in alignment with company policies and organizational standards, delivering exceptional service quality.
- Conduct thorough benefit investigations for patients by initiating outbound calls to payers, confirming insurance benefits, and addressing any reimbursement barriers.
- Document and verify patient-specific benefits, including coverage details, cost-sharing, and provider access options.
- Identify coverage limitations and strategize on expediting patient access to medications.
- Initiate and manage the prior authorization process and claims appeals as needed.
- Report reimbursement trends or coverage delays to management.
- Act as a liaison between field representatives, healthcare providers, and patients.

