Patient Access Coordinator - 11am - 8pm - Healthcare Benefits Exp

Unclassified - Lake Mary, FL

Part-time - Entry Level

Lake Mary, FL

1,001-5,000 employees

About the position

In this role, you will assist patients in accessing their benefits and co-pay cards while also scheduling the delivery of prescriptions provided through the specialty pharmacy. Your work will be conducted within the limits of standard or accepted practice, ensuring that all actions align with the company's core values of respect, honesty, integrity, diversity, inclusion, and safety. As part of a larger organization that has grown from a single grocery store in Cincinnati to the nation's largest grocer with nearly 2,800 stores across 35 states, you will be contributing to a mission that emphasizes the importance of food and community. The company prides itself on creating amazing experiences for customers and employees alike, with a focus on feeding the human spirit. Here, you will find a supportive environment that values your contributions and encourages your growth, whether you are seeking a part-time position or a new career path. Your responsibilities will include communicating with patients to gather necessary information for processing prescriptions, refills, and accessing benefits. You will investigate and verify benefits for pharmacy and medical third-party claims, ensuring that all necessary approvals are obtained. Additionally, you will track and report service issues that may arise during the authorization process and follow up with specialty pharmacies to confirm prescription transfers. Your role will also involve documenting all case activities and communications accurately in the computer system, ensuring compliance with regulatory requirements and organizational standards. This position requires a strong commitment to providing the best available level of service and quality to our patients, while also maintaining a focus on workflow efficiency and business needs.

Responsibilities

• Assist patients with access to benefits and co-pay cards.
• Schedule delivery of prescriptions provided through the specialty pharmacy.
• Communicate with patients to obtain information required to process prescriptions, refills, and access benefits.
• Investigate and verify benefits for pharmacy and medical third-party claims for assigned cases.
• Complete status checks with insurance companies regarding prior authorization and appeals.
• Obtain approval information and activate co-pay cards based on eligibility and specific drugs prescribed.
• Track, report, and escalate service issues arising from requests for authorizations or financial assistance.
• Notify patients when their prescription has been transferred and follow up with specialty pharmacy to confirm receipt.
• Coordinate verbal transfers by a pharmacist if specialty pharmacy has no record of prescription.
• Complete assessments mandated by manufacturer contracts or operations and facilitate patient enrollment with manufacturer Hubs when required.
• Document case activity, communications, and correspondence in the computer system.
• Ensure compliance with regulatory requirements and organizational standards.
• Perform or assist with any operations required to maintain workflow and meet business needs.
• Perform other related duties as assigned.

Requirements

• Minimum of a High School Diploma or GED.
• 1 year of proven work experience in a healthcare or customer service industry.
• Superior telephone customer service skills.
• Demonstrated strength in listening, oral, and written communications in English.
• Excellent data management software skills with adaptability to internal systems.
• Demonstrated ability to manage a range of priorities and meet time commitments.
• Excellent knowledge of insurance benefit investigation processes and techniques.
• Strong organizational skills and attention to detail.

Nice-to-haves

• Any additional training in pharmacy/medical benefit access and requirements.
• Previous experience in a call center where performance was measured.
• Healthcare experience with a basic understanding of clinical terms and benefits investigation.

Benefits

• Opportunities for career growth and development.
• Supportive work environment that values diversity and inclusion.
• Flexible scheduling options.