Sr Benefit Investigation Specialist

Summary

Job Description

e Account Care Educator (ACE) serves as a single point of contact within the Patient Solutions department, supporting prescribers, patients, and field agents across an assigned territory. This role bridges communication between patients and support programs, identifying appropriate assistance programs, guiding next steps, and coordinating with other Assist resources to help patients achieve successful outcomes. ACEs handle inbound calls, aim for one-call resolution, and manage the reimbursement process, including insurance billing, claims submission, and denial resolution for both Medicare and commercial insurance. The role also carries responsibility for identifying and reporting adverse events and safety information in accordance with program requirements.

KEY RESPONSIBILITIES

• Single point of contact for questionsandinquiriesfromtheprescriber, patient, and field agent by territory.

• Identifies applicable programs and facilitates next steps. • Holistically communicates the statuses of all patient support activities.

• Liaison with other program-specific Assist resources to secure outcomes for active patients.

• Accepts inbound calls for assigned territory or overflow of other territories and provides one call resolution support.

• Ensuresprotectionisinsured.

• Performs other related duties as assigned by management.

• Identify and report adverse events pursuant to program requirements.

• Identify, document, and report safety information.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:

Skills and Requirements

HS Diploma or GED

Computer Skills: Microsoft Office

2+ years of medical benefit investigation experience- buy and bill experience

Experience working with and explaining insurance coverage

Experience working w all the major payors and DR offices

Experience w patient assistance programs, financial assistance programs Call Center Experience

Experience w enrollment,

Pharmacy Experience

Salesforce Experience

Job Description

Job Description

e Account Care Educator (ACE) serves as a single point of contact within the Patient Solutions department, supporting prescribers, patients, and field agents across an assigned territory. This role bridges communication between patients and support programs, identifying appropriate assistance programs, guiding next steps, and coordinating with other Assist resources to help patients achieve successful outcomes. ACEs handle inbound calls, aim for one-call resolution, and manage the reimbursement process, including insurance billing, claims submission, and denial resolution for both Medicare and commercial insurance. The role also carries responsibility for identifying and reporting adverse events and safety information in accordance with program requirements.

KEY RESPONSIBILITIES

• Single point of contact for questionsandinquiriesfromtheprescriber, patient, and field agent by territory.

• Identifies applicable programs and facilitates next steps. • Holistically communicates the statuses of all patient support activities.

• Liaison with other program-specific Assist resources to secure outcomes for active patients.

• Accepts inbound calls for assigned territory or overflow of other territories and provides one call resolution support.

• Ensuresprotectionisinsured.

• Performs other related duties as assigned by management.

• Identify and report adverse events pursuant to program requirements.

• Identify, document, and report safety information.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:

Skills and Requirements

HS Diploma or GED

Computer Skills: Microsoft Office

2+ years of medical benefit investigation experience- buy and bill experience

Experience working with and explaining insurance coverage

Experience working w all the major payors and DR offices

Experience w patient assistance programs, financial assistance programs Call Center Experience

Experience w enrollment,

Pharmacy Experience

Salesforce Experience