Patient Access Case Manager

Job Description

Location: Work From Home – Applicants must reside in West Virginia

We are seeking an experienced Patient Access Case Manager to support a national patient access program focused on helping individuals navigate the treatment process from prescription to therapy initiation. This work from home position is ideal for someone who combines clinical knowledge with empathy, organization, and a strong understanding of patient access and reimbursement procedures. The Case Manager plays a critical role in ensuring patients, providers, and payers remain connected throughout each stage of the care journey while maintaining full compliance with HIPAA and program standards.

Responsibilities:

• Serve as the main point of contact for assigned patient cases, ensuring each referral moves efficiently through the intake and authorization process.
• Conduct proactive outreach to patients, providers, and payers to verify benefits, coordinate prior authorizations, and resolve case-related questions.
• Review documentation and communicate updates regarding case status, coverage details, and next steps for prescription fulfillment.
• Educate patients and healthcare professionals on available program support, reimbursement options, and coverage processes.
• Maintain accurate and compliant records using designated systems while safeguarding all patient information in accordance with HIPAA.
• Collaborate with internal teams to resolve access barriers and improve patient support workflows.
• Identify trends, report issues such as claim delays or denials, and assist in process improvements that enhance efficiency and service quality.
• Demonstrate sound judgment, professionalism, and empathy in every interaction.
• Support program initiatives and other assigned responsibilities as needed.

Qualifications:

• Bachelor’s degree preferred, or 3–5 years of relevant case management or patient support experience.
• Minimum 2 years of experience in healthcare, pharmacy, or insurance-related environments.
• Strong understanding of reimbursement processes, including benefit investigations, prior authorizations, and appeals.
• Excellent verbal and written communication skills with a high level of accuracy and organization.
• Ability to handle confidential health information responsibly and in compliance with HIPAA regulations.
• Experience using CRM or case management systems, along with Microsoft Teams, Outlook, and Excel.
• Ability to work independently while managing multiple priorities and deadlines.

Schedule & Work Environment:

• Full-time, work from home position.
• Standard operating hours between 8:00 AM and 8:00 PM EST, Monday through Friday.
• Reliable high-speed internet and a private, HIPAA-compliant home workspace required.

Salary Range: The salary range for this position is $39,500 – $56,000 a year ($19.00 – $27.00 per hour), based on experience.

Interview Process: Selected candidates will participate in a multi-step interview process, which will include a screening call with TalentLNX and one or more virtual interviews with Senior Leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds, and we encourage all qualified candidates to apply for our job opportunities.