Senior Patient Access Representative

Orsini - Rare Disease Pharmacy Solutions

. Provide day-to-day oversight for frontline Benefits Verification and Prior Authorization staff .

Posted 11/5/2026full-timeRemote • United StatesSenior💰 $25 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Benefits Verification and Prior Authorization processes, with a strong focus on auditing, staff training, and process improvement. Capable of managing complex issues and ensuring compliance with payer requirements and HIPAA regulations.

Highest-signal resume keywords

Benefits Verification OversightPrior Authorization ManagementAudit and ComplianceStaff Training and DevelopmentPayer Requirements Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Benefits VerificationPrior AuthorizationAudit ProcessesPolicy InterpretationDocumentation StandardsReimbursement Risk AssessmentPrescription-Based Unit CalculationsData AnalysisHIPAA Compliance

Soft Skills

LeadershipConstructive FeedbackOrganizational SkillsAnalytical SkillsVerbal Communication

Industry Keywords

Specialty PharmacyMajor Medical InsuranceMedicareMedicaidCommercial Payer Requirements

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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