Are you an empathetic, customer-centric healthcare professional looking for a rewarding, fully remote case management opportunity? We are seeking a dedicated Patient Access Case Manager to support specialty pharmaceutical programs!
In this key remote position, you will guide patients through their care journey, removing barriers so they can access, afford, and complete life-changing specialty drug therapies. Working a assigned 8-hour shift between 7:00 AM and 7:00 PM CST (Monday through Friday), you will monitor system queues for new patient cases, contact insurance carriers to obtain and verify benefit details, and conduct outbound calls to communicate coverage determinations, co-pays, and dispensing specialty pharmacies. You will also assess patients for financial assistance and foundation funding, mediate complex payer or pharmacy issues, and document all interaction details in proprietary software while delivering compassionate, high-touch support. If you bring strong healthcare or pharmacy benefits experience, sharp multitasking capabilities, and a commitment to patient advocacy, this role offers an ideal environment to showcase your expertise.
salary: $19.99 - $20 per hour shift: First work hours: 8 AM - 5 PM education: High School
Responsibilities
Key Responsibilities:
- Monitor system queues for incoming patient cases and maintain complete account records throughout the enrollment pipeline.
- Contact insurance carriers to obtain, verify, and document accurate benefit information to minimize claim processing delays.
- Conduct outbound calls to patients to confirm coverage approvals or denials, co-pay amounts, and specialty dispensing pharmacy details.
- Assess patient eligibility for co-pay assistance, alternative foundation funding, and financial assistance programs.
- Mediate complex payer and pharmacy issues to achieve positive resolutions and de-escalate patient concerns.
- Identify, document, and submit Adverse Events in strict accordance with mandatory regulatory protocols.
Requirements:
- High School Diploma or GED required; additional education preferred.
- Previous experience in healthcare, insurance, pharmacy benefit management (PBM), or specialty pharmaceuticals preferred.
- Familiarity with Medicare, Medicaid, commercial payer practices, prior authorizations, or appeals highly desired.
- Minimum typing speed of 40 WPM with strong data entry and MS Excel skills.
- Dedicated, private home workspace with hardwired high-speed broadband internet (15 Mbps download / 5 Mbps upload minimum).
- Full availability for 4–6 weeks of mandatory virtual onboarding training (Monday – Friday, 8:00 AM – 5:00 PM CST).
Skills
- Business operations
- Google for Business Suite
- Problem Solving
Qualifications
- Years of experience: 2 years
- Experience level: Experienced
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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.