Patient Access Coordinator
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Job Description
Patient Access Coordinator supporting Pfizer Primary Care patients with treatment access, reimbursement, prior authorization, and care navigation. Coordinating providers, HUBs, pharmacies, and payers.
Responsibilities:
- Coordinate and manage patients’ access to necessary treatments and resources under Pfizer Primary Care
- Coordinate with healthcare providers, HUBs, pharmacies, payers, and other stakeholders
- Conduct benefit investigations and contact payers to research coverage and benefits
- Educate patients on access resources, insurance coverage, financial assistance options, and Pfizer patient access programs
- Conduct patient welcome calls and guide patients through the healthcare system
- Educate providers and patients on prior authorization, medical exception, appeals processes, and utilization management criteria
- Maintain accurate patient records, insurance information, and access documentation in approved CRM systems
- Work with healthcare providers to gather information and coordinate care plans
- Identify access barriers, analyze data, and recommend process improvements
- Provide support and assistance to patients and their families throughout the access process
- Collaborate with Field Access Leads and HUB Points of Contact, including leading access connect calls
- Stay informed about healthcare industry changes, treatments, insurance policies, and regulations
- Handle sensitive patient information confidentially
- Collaborate with internal and external functions on patient access and order/prescription management
- Coordinate with Pfizer colleagues and Patient Support Program/Hub staff to resolve access issues
- Build trust through consistent follow-up and knowledge of access pathways
- Influence stakeholders without direct authority and connect customer insights to approved offerings
- Participate in monitoring, quality improvement initiatives, and training
- Adhere to business rules, work instructions, and SOPs
- Recommend process and efficiency improvements
- Manage engagements using technology platforms and CRM systems such as POLARIS
Requirements:
- Bachelor's degree in a science or health-related field
- Minimum 10 years of total experience in the healthcare field, including at least 7 years in care coordination/case management/reimbursement
- Experience working with a Field Reimbursement Manager/Patient Coordinator/Nurse Coordinator/Patient Navigator
- Prior experience working with a HUB
- Expertise in reimbursement activities, BI/BV, Prior Authorization, and Appeals Assistance
- Travel 5-10%
- Live in the time zone of the assigned geography
- Broad therapeutic area knowledge in primary care and specialty accounts
- Prior experience working in a specialty pharmacy or with payers
- Minimum 2-3 years of medical billing or insurance claim management experience, preferably in the Pharmaceutical/Biopharmaceutical sectors
- Strong organization
- Excellent written and verbal communication skills
- Strong relationship-building skills, especially with elderly populations
- Demonstrated trust, integrity, empathy, and patience
- Ability to deliver concise and impactful presentations
- High attention to detail and organizational skills
- Exceptional critical thinking and ability to explain complex processes
- Understanding of specialty pharmaceuticals and patient journeys
- Adherence to regulatory and compliance standards
- Strong collaboration and networking capabilities
- Candidates must be authorized to be employed in the U.S. by any employer
- U.S. work visa sponsorship is not available for this role now or in the future
- This position requires permanent work authorization in the United States
Benefits:
- 401(k) plan with Pfizer Matching Contributions and additional Pfizer Retirement Savings Contribution
- Paid vacation, holidays, and personal days
- Paid caregiver/parental and medical leave
- Health benefits including medical, prescription drug, dental, and vision coverage
- Global Performance Plan with a bonus target of 17.5% of the base salary
- Eligibility to participate in Pfizer’s share based long term incentive program
- Relocation support may be available based on business needs and/or eligibility
- Comprehensive and generous benefits and programs to help colleagues lead healthy lives
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