Consumer Access Specialist

AssistRx has engineered the perfect blend of technology and talent to provide life sciences companies with an efficient solution to improve patient uptake, visibility and outcomes. Our talented team members provide therapy and healthcare system expertise to help patients achieve better results from care. As a growing organization, AssistRx views our people as our strongest asset. Join us as we continue to make a difference

• Start Date: Monday, December 12th
• Location: Overland Park, Kansas - Employees on this team will remain on-site for training then have the opportunity to go remote.
• Schedule: 8-hour shifts will be available within 8am - 8pm EST Monday through Friday (NO WEEKENDS OR HOLIDAYS)
• Pay Range: $18 - 20/hour with an opportunity for growth!

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. This role 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

Requirements

• In-depth understanding and experience with 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
• Salesforce system experience preferred

Benefits

• Medical, Dental and Vision benefits become effective the first day of the month following 30 days of employment.
• Employees are fully vested in their 401(k) after 90 days of employment.
• PTO is preloaded into employees account based on hire date. Year one employees are prorated with 100 hours (12.5 days) and then increased to 140 hours (17.5 days) at year two.
• Vacation bonus based on tenure ($1,000/upon 3 year anniversary and $2,500/ upon 5 year anniversary)

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.