$60K - 85K a year
Provide patient advocacy and coordination for specialty pharmaceutical access including prior authorizations, appeals, and assistance programs.
Bilingual Spanish, 2+ years relevant experience in pharmacy benefit management or related roles, proficiency in Microsoft Office, knowledge of medical claims, and experience with prior authorization and patient assistance programs.
Description: • Serve as a patient advocate removing barriers for patients accessing specialty pharmaceuticals • Act as single point of contact providing inbound/outbound phone support to patients, caregivers, and providers to determine eligibility • Coordinate patient access to therapies, conduct follow ups, and facilitate co-pay assistance programs and patient assistance programs (PAP) • Provide day-to-day oversight and coordination of caseload to ensure timely completion of case elements and tasks • Responsible for prior authorization and appeal processing communications with patients, healthcare providers, field reimbursement representatives and other stakeholders • Communicate patient benefits and responsibility timely and accurately • Assess and refer patients for special programs/services when appropriate • Perform quality checks on cases and report trends to leadership • Adhere to quality and production standards and comply with company, state and federal safety and environmental programs • Troubleshoot complex cases spanning multiple disease-states and interface with key stakeholders to ensure optimal start to therapy • Report Adverse Drug Events and forward product quality complaints to manufacturers • Other duties as assigned Requirements: • Bilingual (Spanish) • Bachelor’s degree OR six years of relevant working experience • Two (2) or more years of relevant experience in pharmacy benefit management preferred • Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred • Proficient in Microsoft Office applications • Knowledge of medical and claims processing terminology • Excellent written/verbal communication to include providing clear instructions • Experience with prior authorization and appeal processing • Experience coordinating patient access to specialty pharmaceuticals and assistance programs • Ability to perform quality checks and report trends • Ability to report Adverse Drug Events and recognize product quality complaints Benefits: • Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401k with company match* • Tuition reimbursement • Flexible work environment • 20 Days PTO Annually (accrued) • Paid Holidays • Employee assistance programs • Medical, Dental, and vision coverage • HSA/FSA • Telemedicine (Virtual doctor appointments) • Wellness program • Adoption assistance • Short term disability • Long term disability • Life insurance • Discount programs
This job posting was last updated on 9/10/2025