Cycle Pharmaceuticals · 18 hours ago
Access Specialist
Oregon, OH
Full-time
Hybrid
Mid Level
$80K/yr - $85K/yrCycle Pharmaceuticals is a company focused on improving patient outcomes through innovative support services. They are seeking an Access Specialist II to provide guidance on access, affordability, and solutions for patients and healthcare providers, ensuring timely and accurate support throughout the care journey.
Pharmaceutical
Responsibilities
Obtain insurance verification and benefits from insurance companies and leveraging additional sources such as insurance carrier websites
Ensure that all documents and information are up to date and correct in the system
Prepare benefit summaries and deliver this information to Health Care Professionals and Patients via phone, fax, email, and letters
Educate Health Care Providers and Staff regarding prior authorization and appeals process & documentation including highly specific, payer-based requirements
Supply all necessary prior authorization requirements to Health Care Professionals based on the insurance company’s requirements, following Cycle Pharma’s Compliance SOPs and regulatory guidance
Support patient’s needs for alternate funding scenarios including free drug and copay and enrolling appropriate patients
Triage orders to Specialty Pharmacies including follow-up calls/emails to gain knowledge of the status of those orders
Assist with answering any incoming telephone calls or emails within the shared inbox
Build strong, collaborative relationships with patients, caregivers, insurers, and colleagues to promote service excellence and teamwork at Cycle Pharma
Work closely with the Clinical Education Managers and support with any other duties as required
Qualification
Required
Prior experience within the field of health sciences
Proven experience in Benefit Investigations and Prior Authorization processes, with a strong understanding of industry documentation standards
Strong knowledge within Copay and Free Drug Assistance Programs within the Healthcare or Pharmaceutical industry
Proficient in using CRM systems (Customer relationship management) such as SalesForce, Veeva or Microsoft Dynamics
Familiar with operating in highly regulated environments, ensuring full compliance with industry policies and procedures
Prior reimbursement experience with ability to communicate complex reimbursement scenarios to patients and medical professionals
Strong background in case management and coordinating with patient support services
Excellent organizational skills with the ability to plan, prioritize and meet deadlines effectively
Positive, relationship-focused mindset, with strong interpersonal and communication skills
Willing and able to travel up to 50%, including visits to healthcare providers, specialty pharmacies, and company headquarters in the UK for training and business reviews
Preferred
Experienced in working in biotech/pharmaceutical industry for a drug manufacturer or Hub Services provider
Rare disease experience
Benefits
Competitive salary based on experience
A collaborative high performing work environment
Performance based bonus
Opportunity to join a fast growing and ambitious business
100% employer paid membership for Private Health Insurance
Life Insurance
401k plan
Company
Cycle Pharmaceuticals
Cycle Pharmaceuticals is a pioneering pharmaceutical company.
Founded in 2012
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
$25MKey Investors
Deutsche Bank
2020-09-07Debt Financing· $25M
Leadership Team
James Harrison
Group CEO and Founder
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Company data provided by crunchbase