Patient Access Specialist

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Assist uninsured, underinsured, and patients facing limited benefit coverage or substantial out-of-pocket prescription and medical costs who may qualify for the AbbVie Patient Assistance Program.

• Deliver exceptional customer service to patients and healthcare providers regarding specialty prescription medications.

• Oversee the review of application documentation.

• Perform insurance investigations as needed using payer calls, insurance intelligence, and online resources.

• Examine financial documents for completeness and evaluate program eligibility.

• Offer expertise on medical and prescription insurance coverage, prior authorization procedures, and alternative financial assistance options.

• Implement program standards to approve or reject applications.

• Engage in outreach to gather any missing information from applications.

• Record patient cases in the CRM in accordance with business rules and policies.

• Receive and manage incoming communications from patients and healthcare providers.

• Complete renewals and year-end recertifications.

• Support special projects aimed at enhancing reimbursement optimization as requested by management.

⛳️ Requirements

• A high school diploma or equivalent is required.

• A college degree or a 2-year Associate Degree is preferred.

• 1–3 years of experience in a call center, healthcare provider, PBM, Specialty Pharmacy, or Retail/Mail Order Pharmacy environment.

• Strong foundational knowledge of insurance (Medical and Pharmacy Benefit) is preferred.

• Familiarity with online benefit verification systems or similar experience is strongly required.

• Excellent customer service skills.

• Strong attention to detail and the ability to manage multiple tasks simultaneously are required.

• Preferred strong analytical skills.

• Ability to communicate ideas clearly in both written and verbal forms.

🏝️ Benefits

• Paid time off (vacation, holidays, sick leave).

• Medical, dental, and vision insurance.

• 401(k) plan.

• Short-term incentive programs.

• Opportunities for remote work.