Position Title: Patient Access Specialist 

Work Location: 11800 Weston Parkway, Cary, NC, USA, 27513

Work Schedule: Monday-Friday 9am - 6pm

Assignment Duration: 3 months

Is this Remote/Hybrid/Onsite?: Onsite

Department: Pharmacy Operations

Reports to: Sr. Manager, Specialty Pharmacy Operations

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.

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.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 20.00/hr.