Accredo - Patient Access Representative III
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POST DATE 8/12/2016
END DATE 11/11/2016
JOB DESCRIPTIONSchedule: Full-time
Job ID: REQ20003806
The Patient Access Representative III performs specialized patient access functions requiring an advanced understanding of insurance benefits and internal processes in order to successfully liaise with Payers, Pharma, Physicians and Patients. This role directly interfaces with external clients and requires a high level of independent judgment in order to establish and maintain effective relationships with clients to gain their trust and support. Relies on experience and knowledge of industry best practices to identify exposures to the company and facilitates leadership s knowledge of pending referrals that may have an adverse impact on company goals and the patient experience. Acts as a liaison between both internal and external resources to reduce client abrasion, facilitate the timely processing of referrals and provide accurate status reporting to clients.
* Performs insurance verification and re-verification of insurance
* Communicates in writing or via telephone with patients, family members, physicians and insurance representatives on eligibility requirements, policy benefits, eligibility determinations and contract provisions
* Maintains accurate and complete documentation of all contacts
* Receive, sort, identify, stamp and log faxed/mailed prior authorization requests
* May distribute incoming mail and fax correspondence to physicians
* Provides administrative support to the prior authorization team including updating and maintaining forms used by the department
* Review co-pay assistance program information to perform verification for patient eligibility by contracting programs to confirm funding information
* Completes other projects and additional duties as assigned
* High school diploma or GED required, bachelor s degree preferred
* 0-1 years of relevant working experience; health insurance experience with medical insurance knowledge and terminology is preferred
* Intermediate data entry skills and working knowledge of Microsoft Office
* Excellent telephone presentation and communication skills
* Demonstrated ability to handle challenging customers in a professional manner with the ability to adapt in a dynamic work environment
* Solid problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions.
ABOUT THE DEPARTMENT
A leading provider of specialty pharmacy services, Accredo improves care for patients through behavioral and clinical expertise.
Accredo offers a broad range of healthcare products and services for individuals with chronic health conditions, such as growth hormone deficiencies, hepatitis C, hemophilia, oncology, multiple sclerosis and rheumatoid arthritis. It also provides comprehensive patient management services, including clinical care management programs, counseling, education, outcomes measurement, social services and reimbursement services.
ABOUT EXPRESS SCRIPTS
Advance your career with the company that makes it easier for people to choose better health.
Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes.
Join the company that Fortune magazine ranked as one of the 'Most Admired Companies' in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services.
We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.
Express Scripts is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation.
Express Scripts is a VEVRAA Federal Contractor.
Express Scripts is an EOE
Express Scripts is an Equal Employment Opportunity employer and does not discriminate in employment opportunities or practices on the basis of race, creed, color, religion, sex, national origin, nationality, ancestry, age, disability or status as a disabled veteran or veteran of the Vietnam era, pregnancy, affectional or sexual orientation, gender identity or expression, marital status, status with regard to public assistance, veteran status, citizenship or membership in any other legally protected class. None of the questions in this application are intended to elicit information regarding any protected characteristics, nor imply any limitation, illegal preferences or discrimination based upon non-job-related information or protected characteristics.Applicants must be able to pass a drug test and background investigation and, depending on position requirements, a Department of Defense background investigation. AA/EOE.