Patient Access Specialist

TL;DR

Patient Access Specialist (Healthcare/Insurance): Managing patient access to medications by coordinating with healthcare providers and insurance payers with an accent on benefit investigations and reimbursement navigation. Focus on resolving complex billing issues, handling prior authorizations, and ensuring compliance with pharmaceutical coverage standards.

Location: Must be based in the United States (Overland Park, KS). Work from home available after 120 days upon meeting goals and manager discretion.

Company

hirify.global leverages custom software and data analytics to streamline medication management and improve patient access to essential therapies.

What you will do

• Conduct benefit investigations via outbound calls to payers to verify insurance coverage, cost shares, and access options.
• Support healthcare providers with coding, billing, and navigating complex reimbursement barriers.
• Initiate and manage the prior authorization process and claims appeals for an assigned caseload.
• Document patient-specific benefits and identify restrictions to expedite medication access.
• Monitor and report reimbursement trends or coverage delays to management.

Requirements

• Must be authorized to work in the United States; sponsorship is not available.
• 2-5 years of experience in benefit investigation and insurance coverage analysis.
• 3-5 years of experience interacting with healthcare providers regarding insurance plan requirements.
• In-depth understanding of Buy & Bill, Major Medical, and Pharmacy Benefit Coverage.
• Excellent verbal communication skills and computer literacy.

Nice to have

• Experience with the Salesforce system.

Culture & Benefits

• Preloaded PTO (100-140 hours) and tenure-based vacation bonuses.
• Matching 401(k) with immediate vesting.
• Comprehensive medical, dental, vision, life, and short-term disability insurance.
• Promote-from-within culture via the Advance Gold growth program.
• Potential for work-from-home flexibility after an initial 120-day period.