Patient Copay Support Representative

This is a Fully Remote Job About Our Client: The organization operates within the healthcare support services industry, focusing on patient assistance related to prescription costs and access programs. It addresses challenges patients face with medication affordability, pharmacy processing issues, and insurance complexities by providing comprehensive support through copay and financial assistance programs. The organization facilitates enrollment, eligibility screening, and benefit verification to enhance patient access to necessary treatments. About the Opportunity: The PATIENT COPAY SUPPORT REPRESENTATIVE role is designed to deliver direct assistance to patients and other stakeholders regarding prescription cost concerns and insurance benefits. This position is responsible for managing high volumes of inquiries, verifying patient eligibility for assistance programs, resolving pharmacy claim issues, and maintaining accurate documentation. The role contributes to improving patient experience and access by providing clear, empathetic communication and navigating complex benefit and copay processes. Responsibilities: Respond to inbound contacts regarding prescription costs, access programs, and enrollment. Explain healthcare and pharmacy benefit concepts in accessible terms. Screen patients for eligibility and facilitate enrollment in copay and financial assistance programs. Assist with copay program inquiries including status, balances, and limits. Obtain and document insurance benefit and coverage information. Interpret explanation of benefits and resolve common pharmacy claim rejections. Coordinate with payers, pharmacies, providers, and internal teams to resolve issues. Monitor prior authorization statuses and coordinate necessary follow-ups. Maintain accurate patient and insurance records in CRM or case management systems. Ensure compliance with HIPAA, privacy, and security protocols. Escalate clinical, legal, or complex issues following established procedures. Adhere to program policies, quality standards, and security requirements. Requirements: High School Diploma or GED. Knowledge of U.S. healthcare insurance concepts and pharmacy terminology. Strong communication and customer service skills. Ability to manage technology systems and multitask effectively. Attention to detail and accuracy in documentation. Ability to maintain professionalism in sensitive situations. Commitment to confidentiality and compliance standards. Pay Range and Compensation Package: The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.