[Hiring] Patient Access Specialist @MMC

Role Description

Are you an experienced healthcare professional who understands insurance benefits, medical claims, prior authorizations, reimbursement, or patient access services? We are seeking a Patient Access Specialist, PAS to provide critical support to patients, healthcare providers, and caregivers participating in manufacturer-sponsored patient support programs. This is a remote opportunity for a highly organized, self-motivated professional who can confidently navigate healthcare coverage issues while delivering an exceptional patient and provider experience.

As a Patient Access Specialist, you will help patients and providers navigate healthcare benefits, reimbursement, and access-related processes. Responsibilities may include:

• Provide advanced support to patients, healthcare providers, and caregivers
• Assist with medical billing and coding inquiries
• Provide claims assistance, tracking, and submission support
• Assist with prior authorizations and authorization tracking
• Coordinate insurance benefits
• Communicate benefit verification results
• Conduct patient welcome calls
• Research alternative coverage options
• Assist with appeals and denied claims
• Complete patient intakes and report adverse events as directed
• Research payer trends, reimbursement delays, billing denials, claim denials, pricing errors, and payment issues
• Process correspondence accurately and efficiently
• Coordinate with internal and external service providers to ensure established Service Level Agreements (SLAs) are met
• Maintain strict confidentiality of patient-sensitive information
• Work independently from assigned phone and system queues
• Analyze moderately complex issues and determine appropriate action using established procedures
• Assist with additional patient support services, including benefit verifications and Patient Assistance Program (PAP) determinations

Qualifications

• High school diploma or GED required
• 4+ years of directly related, progressively responsible experience, or an equivalent combination of education and experience
• A two-year degree may substitute for two years of the experience requirement
• A four-year degree may substitute for four years of the experience requirement
• Strong verbal and written communication skills
• Advanced organizational skills and attention to detail
• Strong interpersonal and relationship-building abilities
• Strong mathematical skills and basic analytical abilities
• Ability to work independently in a structured, queue-based remote environment
• Ability to follow established policies, procedures, and productivity expectations
• Proficiency with Microsoft Excel, Outlook, and Word

Requirements

• Knowledge or experience in patient access or patient support services
• Health insurance benefits
• Benefit verification
• Medical claims
• Prior authorizations
• Appeals and denials
• Medical billing and coding
• Coordination of benefits
• Healthcare reimbursement
• Pharmacy operations
• Patient Assistance Programs (PAP)
• Healthcare or pharmaceutical customer service

Remote Work Requirements

This is a BYOD (Bring Your Own Device) remote position. Candidates must be prepared to use their own compatible equipment to perform the essential functions of the role. Because this position handles patient-sensitive information and requires frequent communication with patients and healthcare professionals, candidates should have a professional, quiet, and distraction-controlled workspace appropriate for handling confidential healthcare-related conversations.

Work Environment & Physical Requirements

This is primarily a sedentary, computer-based position. Candidates should be comfortable:

• Spending 75% or more of the workday working directly on a computer
• Performing repetitive computer and keyboard functions
• Communicating regularly by phone and electronically
• Maintaining visual focus for extended periods
• Managing multiple priorities and deadlines
• Handling challenging or stressful situations professionally

Benefits

• Medical, dental, and vision coverage
• Life and disability insurance
• Additional voluntary benefits