Patient Benefits Representative

Job Title: Patients Benefits Representative Pay: $20-$22 an hr | Bi-weekly Job Type: Onsite in Cary, NC Shift Options: Work Schedule: Monday - Friday 9am - 6pnm Patients Benefits Representative Overview: The Patient Access Specialist, Rare/Orphan will be responsible for benefits investigation, prior authorization support, and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures. Essential Duties and Responsibilities • Locate and enter accurate prescription insurance information on patient's profile by processing eligibility checks and adjudicating pharmacy claims. • Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patient • Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process. • Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support options • Serve as a technical resource pertaining to adjudication while identifying areas for improvement. • Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles. • Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner • Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan • Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient's safety • Perform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.)

Created: 2025-10-01