Patient Benefit Navigator

About the role

Responsible for assisting patients in managing their out-of-pocket costs, and working with patients who are underinsured and requiring guidance via assistance programs or pharmaceutical manufacturer programs.

Responsibilities

• Understand and navigate patient assistance via pharmaceutical manufacturer programs and foundations for patients with little or no insurance coverage or those we cannot offer internal assistance by referring them to the manufacturer.
• Confirm that patients are enrolled properly in all assistance programs.
• Work directly with patients to negotiate copayment arrangements.
• Retrieve methods of payment from patients for copays, communicate, and notate.
• Submit timely and accurate financial analyses and financial assistance options for products and services provided upon receipt of request.
• Complete financial assistance review according to established procedures and practices for all requests received for patients receiving specialty therapies on new admissions, therapy changes, or additions to therapy for established patients, for all payer sources.
• Understand the terms and fee schedules for all contracts for which patient requests for assistance are submitted.
• Generate and mail patient assistance enrollment forms and letters per Option Care policy.
• Stay abreast and adhere to Federal, state, and contractual requirements regarding copay assistance plans.
• Act as a liaison between billing, pharmacy, and nursing to assist in resolving financial assistance related to prescription refills.
• Update patient information in the software system to communicate the outcomes of any agreement.

Requirements

• High school diploma and 3 years of relevant experience in the healthcare industry (admissions, verification, intake, billing/collections, or pharmacy).
• Excellent communication and negotiation skills along with a caring and compassionate attitude.
• Ability to work cooperatively and be a liaison between departments.
• Proficient in the use of a personal computer, word processing, and electronic spreadsheets.
• Basic math skills (addition, subtraction, multiplication).
• Working knowledge of medical and prescription insurance coverage.
• Understanding of insurance coverage gaps.
• Ability to research disease states online.

Preferred Qualifications

• State certification, registration, or licensure (Certified Pharmacy Technician).

Pay

Pay range is $16.40-$25.21. Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Benefits

• Medical, Dental, & Vision Insurance
• Paid Time Off
• Bonding Time Off
• 401K Retirement Savings Plan with Company Match
• HSA Company Match
• Flexible Spending Accounts
• Tuition Reimbursement
• myFlexPay
• Family Support
• Mental Health Services
• Company Paid Life Insurance
• Award/Recognition Programs