About this opportunity
Spectraforce Technologies lists this Patient Benefit Representative opportunity in cary, North Carolina. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Position Title: Patient Benefit Representative/Patient Access Specialist
Work Location: Cary NC 27513
Assignment Duration: 3 Months
Work Schedule: Monday - Friday 9am - 6pm, 10am-7pm
Work Arrangement: Hybrid (in office twice a week - Monday and the team member can select the other day
Position Summary:
The Patient Access Specialist, Rare/Orphan will be responsible for benefits investigation, prior authorization support, and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures.
Background & Context:
At our organization, our mission is to simplify access to medication and deliver personalized care that helps patients achieve the best-possible outcomes - one patient, one partner, one therapy at time.
Key Responsibilities:
* Locate and enter accurate prescription insurance information on patient's profile by processing eligibility checks and adjudicating pharmacy claims.
* Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patient
* Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process.
* Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support options
* Serve as a technical resource pertaining to adjudication while identifying areas for improvement.
* Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
* Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner
* Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan
* Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient's safety
* Perform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.)
Qualification & Experience:
* CPhT (Certified Pharmacy Technician) preferred, not required. Must be current, without restrictions, and in good standing
* High school diploma required
* 2+ years prior experience working in a pharmacy or other health care setting required
* Experience with insurance eligibility and prior authorization processes
* Competent in basic computer skills and proficiency in Microsoft applications
* Conscientious, detail oriented with the ability and desire to solve problems to help our patients
* Flexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goal
* Highly motivated and committed to excellence with a positive attitude
* Strong interpersonal and communication skills; able to engage empathetically with patients and caregivers.
* Understanding of HIPAA, patient privacy, and compliance regulations.
* Strong prioritization and time management skills
* Proficiency in quickly and thoroughly understanding patient and provider needs
* Demonstrated ability to communicate complex concepts with high efficacy
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.