Senior Patient Access Representative

🔥 6 minutes ago

🇺🇸 United States – Remote

💵 $25 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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Orsini - Rare Disease Pharmacy Solutions

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1987

🏥 Healthcare

💊 Pharmaceuticals

📦 Logistics

Healthcare • Pharmaceuticals • Logistics

Orsini is a specialty pharmacy and rare-disease focused pharmacy solutions provider. The company partners across patients, providers, biopharma and payors to support complex therapy programs and simplify patient access to therapies. Its offerings include specialty pharmacy services, patient services hub, third‑party logistics, home infusion and nursing, and an ORBIT technology / real-world data platform; it also serves as a contracted specialty pharmacy for therapies such as Gilead’s Hepcludex (bulevirtide).

📋 Description

• Provide day-to-day oversight for frontline Benefits Verification and Prior Authorization staff • Assign work, monitor queues, coordinate coverage, follow up on productivity, and support staff questions • Perform routine and complex audits of benefit investigations, prior authorization submissions, recurring authorizations, approvals, denials, and supporting documentation • Coach staff on audit findings and deliver timely feedback • Support onboarding and ongoing training • Identify recurring knowledge or process gaps for leadership • Serve as the first point of escalation for complex or urgent Benefits Verification and Prior Authorization issues • Research payer requirements and coordinate resolutions with Admissions leadership, Audit, Accounts Receivable, clinical teams, and other partners • Track audit results, turnaround times, work quality, trends, and outstanding issues • Provide updates and recommendations to the Admissions Sr. Manager • Support process improvement, standard work, policy updates, and readiness for new therapies or payer changes • Perform other duties or projects as assigned

🎯 Requirements

• High school diploma or equivalent from an accredited school required • Minimum 3 years of related specialty pharmacy, benefits verification, prior authorization, reimbursement, or major medical insurance experience preferred • Demonstrated ability to lead daily work, support staff, provide constructive feedback, and reinforce performance expectations • Strong knowledge of major medical benefits, Medicare, Medicaid, commercial payer requirements, and policy interpretation • Working knowledge of prior authorization requirements, authorization date spans, prescription-based unit calculations, and documentation standards • Ability to audit work objectively, identify root causes and reimbursement risk, and communicate clear corrective action • Strong organizational, analytical, written, and verbal communication skills • Ability to prioritize competing work in a fast-paced environment and manage urgent patient or payer escalations • Must be highly detail oriented and able to handle protected health information in accordance with HIPAA requirements

🏖️ Benefits

• Medical Coverage • Dental Coverage • Vision Coverage • 401(k) with employer match • Accident and Critical Illness coverage • Company-paid life insurance options • Generous PTO • Paid holidays • Floating holidays • Tuition reimbursement program

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