Company Description

At RxLightning our mission is to provide every patient with accelerated access to the therapies they need. Fueled by a deeply personal mission, our powerhouse founder Julia Regan started RxLightning to help ensure that any patient that needed a specialty medicine to live their life got it on time, every time.

We are honored to be the recipients of awards such as Startup of the Year and Tech Product of the Year from TechPoint, named one of the fastest growing companies in Louisville, a 2020 Vogt winner, among others.

Your Role

When you join the team as a Patient Access Navigator, you'll have the opportunity to make a

difference in the lives of our patients each day as they look to you as part of their dedicated support

team for helping them navigate the complicated process to getting access to their Oncology

medication. You'll compassionately deliver an exceptional experience to many patients per day

always remembering that patient care is of utmost importance.

A typical day in this role will include providing in-depth knowledge of our client programs by

working directly with patients, healthcare providers, and insurance companies to answer inquiries,

process service requests, assess benefits coverage, and manage through barriers, in a compliant

manner, that stand in the way of patients and their access to therapy. The Patient Access Navigator

works in a dynamic and compassionate customer service role.

Essential Duties And Responsibilities Including But Not Limited To The Following Benefit Verification:

• Performing data intake and review to identify information that is missing and/or incorrect within program service requests/program applications.

• Performing patient level benefits verifications as applicable for all major medical and pharmacy benefits plans.
• Completion of the template forms that provide patient level benefits Coverage Determination Summary.
• Coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance.

Patient Assistance:

• Review of patient assistance enrollment forms and any supporting documentation to assess patient eligibility for participation as per SOPs and program guidelines.
• Determination of patient’s eligibility based upon program criteria for qualification.
• Communicating the patient’s eligibility to the patient, healthcare provider, and/or
• pharmacy.
• Answer and assist inbound callers through resolution utilizing answers to frequently asked questions or by warm transferring callers to other appropriate individuals.
• Actively listen to each customer, assess needs, and respond with demonstrated patience and courtesy.
• Review and identification of information that is missing and/or incorrect within program service requests/program applications.
• Reporting of Adverse Events/ Product Complaint inquiries received in accordance with SOP and good manufacturer practices.
• Provides timely feedback to the company regarding service failures or customer concerns
• Effectively uses our internal technology platform to complete claims processing and keep
• workflows moving.
• Communicate with key medical practice accounts, sales representatives regarding the
• status of cases. Provide consultative services where issues arise on how obstacles can be
• overcome to get patient on therapy.
• Patient Access Navigators are expected to be patient focused and committed to
• providing the highest quality customer service all while maintaining a sense of compliance and commitment to abiding by company policies and procedures.

This job might be for you if you possess the following personal attributes (requirements of the

role):

• Service minded; focus on recognizing and meeting the needs of others (especially Oncology patients and care partners)
• Ability to handle personal health information with confidentiality
• Commitment to honesty and integrity
• Professionalism and a strong sense of proper business and customer service etiquette
• Clear verbal and written communication skills
• Accountability for results
• Ability to plan and prioritize tasks and strong attention to detail
• Proficient emotional intelligence (ability to recognize emotions and their effects)
• Ability to manage disruptive impulses and handle potentially stressful customer
• interactions
• Proficient computer skills
• Adaptability to change
• Personal initiative and commitment to team and organizational goals
• Ability to work effectively within a team
• A positive attitude!

Requirements

Preferred Qualifications

• Ability to work a nine-hour shift, lunch included, to cover hours of operation between 8am and 8pm EST (as coordinated with manager)

• 6 months customer service experience, payer benefits experience (reimbursement, prior authorization, etc.), healthcare industry experience or healthcare related certification, license, or equivalent coursework is strongly preferred
• Experience navigating patient access for Oncology medications is strongly preferred
• Bilingual is a plus

Physical Demands & Work Environment

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms.
• Although very minimal, flexibility to travel as needed is preferred

Melissa Kozoman

11/15/2022