Contact Center Patient Access Specialist

📋 Description

• • Lead and manage day-to-day activities of a Patient Access Specialist team supporting patients and healthcare providers across the U.S. via phone, fax, chat, and email, spending approximately 50% of time in direct patient and provider support.
• • Assist patients in understanding access to medication through reimbursement and affordability programs by identifying access pathways and providing resources to overcome barriers.
• • Serve as the subject matter expert for the program team, responding promptly to complex questions regarding patient support programs, insurance coverage, and referral processes.
• • Conduct quality call monitoring for team members and provide timely feedback to improve performance and adherence to program scripts and guidelines.
• • Ensure all patient support requests are accurately captured and tracked within the Case Management system, maintaining compliance with internal protocols and external regulations.
• • Perform in-depth research into patient medication coverage, including benefit investigations, prior authorizations, appeals, and available support programs.
• • Escalate complex cases and identified issues to appropriate program leadership in a timely manner, ensuring resolution within quality and productivity requirements.
• • Coordinate all aspects of patient case management from initiation to completion, utilizing strong interpersonal skills to manage sensitive interactions with patients, providers, payers, pharmacies, and third-party administrators.
• • Educate healthcare providers and patients on available Patient Support programs and the correct referral process to ensure timely case processing.
• • Maintain strict compliance with HIPAA and all patient privacy regulations, safeguarding confidential health information at all times.
• • Compile and disseminate individual monthly program metrics to management, contributing to performance tracking and operational improvements.
• • Disseminate project directives and updates to the team, ensuring alignment with corporate compliance standards and program guidelines.
• • Demonstrate leadership by example, embodying core values of quality, integrity, innovation, accountability, collaboration, and leadership in daily operations.
• • Utilize creativity and critical thinking to develop suggestions for process improvements and innovative solutions to access barriers.
• • Maintain high standards of productivity, attention to detail, and follow-up across all responsibilities, managing competing priorities effectively in a dynamic environment.
• • Work cross-functionally with internal departments and external partners, exhibiting strong teamwork, active listening, and creative problem-solving skills.
• • Adapt quickly to changing program requirements, regulatory updates, and evolving patient needs while maintaining a high level of accuracy and professionalism.
• • Demonstrate a passion for learning and effectively communicate that enthusiasm to team members to foster a culture of continuous improvement.
• • Interact successfully in a culturally diverse workplace, respecting and valuing differences in background, perspective, and experience.