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Pharmacy Case Manager – Patient Access

Pay: $20.00/hour
Schedule: Full-Time | Flexible 8-hour shift assigned between 7:00 AM – 7:00 PM CST

Training Schedule:
Mandatory onboarding /training Monday–Friday, 8:00 AM – 5:00 PM CST for approximately 4–6 weeks.

Job Overview

We are hiring a Pharmacy Case Manager – Patient Access to support patients navigating specialty medication access, insurance verification, pharmacy benefits, and financial assistance programs.

This role is ideal for candidates with experience in healthcare customer service, pharmacy support, patient access, insurance verification, pharmacy benefits management (PBM), specialty pharmacy, prior authorization, reimbursement support, or medical/pharmaceutical case coordination.

In this role, you will work directly with patients, provider offices, pharmacies, and insurance companies to help coordinate medication access, confirm coverage, resolve pharmacy and payer issues, and support patients throughout the approval process.

Key Responsibilities

• Manage patient cases from intake through final approval or denial
• Conduct outbound patient calls to discuss insurance approvals, denials, copays, specialty pharmacy dispensing, and medication access updates
• Verify insurance benefits and patient coverage with Medicare, Medicaid, commercial insurance plans, and pharmacy benefit programs
• Contact insurance companies to obtain and document accurate pharmacy and medical benefit information
• Support patient access to specialty medications and patient assistance programs
• Resolve complex payer, pharmacy, reimbursement, and patient access issues while maintaining a positive patient experience
• Provide compassionate, patient-centered support while maintaining professionalism and quality standards
• Enter detailed and accurate case documentation into company systems while actively speaking with patients and healthcare offices
• Research copay assistance, foundation support, reimbursement programs, and alternative patient funding options
• Process patient applications while maintaining PHI/HIPAA compliance and confidentiality
• Collaborate with leadership and team members regarding patient case progress and escalations
• Identify, document, and report adverse events according to company procedures
• Independently manage a high-volume caseload while meeting productivity and quality expectations

Required Qualifications

• High school diploma or GED required
• Minimum typing speed of 40+ WPM with strong documentation accuracy
• Strong Microsoft Office and computer navigation skills
• Ability to multitask across multiple systems while speaking with patients, insurance companies, providers, or pharmacies
• Strong verbal and written communication skills with a professional, empathetic, patient-first approach
• Experience using Microsoft Teams, Zoom, or video conferencing platforms
• Strong organization, time management, attention to detail, and ability to prioritize multiple cases
• Self-starter with the ability to work independently in a fast-paced, production-based environment
• Reliable attendance and ability to meet performance expectations

Preferred Qualifications

• Experience in healthcare customer service, pharmacy support, insurance verification, patient access, reimbursement support, medical office operations, or pharmaceutical services
  • Pharmacy benefits management (PBM), specialty pharmacy, or pharmaceutical industry experience preferred
  • Knowledge of Medicare, Medicaid, commercial insurance, prior authorizations, appeals, pharmacy claims, reimbursement, or patient assistance programs preferred
  • Previous experience supporting specialty medications, pharmacy case management, or insurance authorization workflows strongly preferred

Ideal Backgrounds

Candidates with experience in the following areas are encouraged to apply:

• Pharmacy Technician Support
• Pharmacy Customer Service
• Insurance Verification Specialist
• Prior Authorization Specialist
• Patient Access Representative
• Medical Call Center Support
• Specialty Pharmacy Support
• Healthcare Case Coordination
• Reimbursement Specialist
• PBM or Pharmaceutical Support Services

Why Join Us?

• Paid training provided
• Opportunity to build experience in pharmacy operations, patient access, insurance verification, reimbursement, specialty pharmacy, and healthcare support
• Career growth potential within healthcare, pharmacy services, and patient access operations

Keywords: Pharmacy Case Manager, Patient Access Specialist, Insurance Verification, Prior Authorization, Pharmacy Benefits, Specialty Pharmacy, PBM, Reimbursement Specialist, Patient Support, Healthcare Customer Service, Medicare, Medicaid, Pharmacy Support, Patient Assistance Programs, Specialty Medication Support