Patient Access Coordinator

This is a fully remote position, open to applicants in Connecticut, +1 more state.

📋 Description

• Facilitate and oversee patient access to essential treatments and resources within Pfizer Primary Care.

• Collaborate with healthcare providers, HUBs, pharmacies, payers, and various stakeholders.

• Perform benefit investigations and engage with payers to explore coverage and benefits.

• Inform patients about access resources, insurance coverage, financial aid options, and Pfizer patient access initiatives.

• Conduct welcome calls for patients and assist them in navigating the healthcare system.

• Provide education to both providers and patients regarding prior authorization, medical exceptions, appeals processes, and utilization management criteria.

• Ensure accurate maintenance of patient records, insurance details, and access documentation within approved CRM systems.

• Collaborate with healthcare providers to collect information and coordinate care plans effectively.

• Identify access challenges, analyze data, and suggest process enhancements.

• Offer support and assistance to patients and their families throughout the access journey.

• Work in partnership with Field Access Leads and HUB Points of Contact, including leading access connect calls.

• Keep abreast of changes in the healthcare industry, including treatments, insurance policies, and regulations.

• Maintain confidentiality when handling sensitive patient information.

• Collaborate with both internal and external teams on patient access and order/prescription management.

• Coordinate with Pfizer colleagues and Patient Support Program/Hub staff to address access challenges.

• Build trust through consistent follow-ups and a thorough understanding of access pathways.

• Influence stakeholders without direct authority and connect customer insights to approved offerings.

• Engage in monitoring, quality improvement initiatives, and training.

• Comply with business rules, work instructions, and SOPs.

• Suggest improvements for processes and efficiency.

• Manage interactions utilizing technology platforms and CRM systems such as POLARIS.

⛳️ Requirements

• Bachelor's degree in a science or health-related discipline.

• A minimum of 10 years of overall experience in the healthcare sector, including at least 7 years in care coordination, case management, or reimbursement.

• Experience collaborating with a Field Reimbursement Manager, Patient Coordinator, Nurse Coordinator, or Patient Navigator.

• Previous experience with a HUB.

• Proficient in reimbursement activities, BI/BV, Prior Authorization, and Appeals Assistance.

• Willingness to travel 5-10%.

• Reside in the time zone of the assigned area.

• Extensive therapeutic area knowledge in primary care and specialty accounts.

• Previous experience working in a specialty pharmacy or with payers.

• At least 2-3 years of experience in medical billing or insurance claim management, preferably within the Pharmaceutical/Biopharmaceutical sectors.

• Strong organizational skills.

• Excellent written and verbal communication abilities.

• Strong relationship-building skills, particularly with elderly populations.

• Demonstrated trustworthiness, integrity, empathy, and patience.

• Ability to deliver concise and impactful presentations.

• High attention to detail and strong organizational capabilities.

• Exceptional critical thinking skills and the ability to clarify complex processes.

• Understanding of specialty pharmaceuticals and the patient journey.

• Commitment to regulatory and compliance standards.

• Strong collaboration and networking skills.

• Candidates must have authorization to work in the U.S. for any employer.

• U.S. work visa sponsorship is not available for this position now or in the future.

• This role requires permanent work authorization in the United States.

🏝️ Benefits

• 401(k) plan with Pfizer Matching Contributions and additional Pfizer Retirement Savings Contribution.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

• Health benefits including medical, prescription drug, dental, and vision coverage.

• Global Performance Plan with a bonus target of 17.5% of the base salary.

• Eligibility to participate in Pfizer’s share-based long-term incentive program.

• Relocation support may be offered based on business needs and/or eligibility.

• Comprehensive and generous benefits and programs designed to help colleagues lead healthy lives.