Eligibility Senior Representative

Job Description

REQUIREMENTS

• High school diploma or equivalent.
• Must be able to work a Monday through Friday schedule between the hours of 9:00AM – 6:30PM EST
• Minimum of 1 year of experience in a phone queue, call center, healthcare, specialty pharmacy, patient access, reimbursement, insurance verification, customer service, or a related field.
• Strong verbal communication, customer service, and problem-solving skills.
• Ability to manage multiple priorities while maintaining accuracy and attention to detail.
• Comfort working in a fast-paced environment where patient needs and business priorities may shift throughout the day.

Preferred

• Experience conducting medical or pharmacy benefit investigations.
• Experience in specialty pharmacy, patient access, reimbursement support, or benefit investigation services.
• Knowledge of specialty drug reimbursement, copay assistance programs, and patient access support services.
• Experience working in a call center or phone queue environment.
• Experience discussing insurance benefits, copays, coinsurance, deductibles, and financial assistance options with patients.

RESPONSIBILITES

• Support patients and prescriber offices through inbound calls related to insurance coverage, patient access, reimbursement support, and referral status.
• Review and confirm patient demographic, insurance, and referral information to help move referrals forward accurately and efficiently.
• Explain insurance benefits, copays, coinsurance, deductibles, and other financial responsibilities in a clear and professional way.
• Help patients understand available copay assistance, manufacturer assistance, and other financial support options.
• Identify barriers that may delay therapy, including insurance, authorization, financial, or coverage concerns, and help coordinate next steps toward resolution.
• Provide accurate updates on referral status, access requirements, and actions needed to support timely patient care.
• Manage escalated patient or prescriber concerns with professionalism, empathy, and sound judgment.
• Meet quality, productivity, and phone queue expectations while creating a positive caller experience.

Are you interested in this position?

Apply by clicking on the “Apply Now” button below!

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