AssistRx · 11 hours ago
Copay Support/Claims Processing Specialist
Maitland, FL
Full-time
Onsite
New Grad, Entry Level
$45K/yr - $52K/yr
0+ years expAssistRx is a company focused on revolutionizing healthcare by improving patient access to essential medications. They are seeking a Copay Support/Claims Processing Specialist responsible for servicing inbound calls and processing claims related to copay programs, ensuring proper claims adjudication, and providing support to patients and prescribers.
Health CareInformation Technology
No H1B
Responsibilities
Quality control of commercial copay programs
Collaborate with internal HUB teams on enrollment discrepancies (missing info and duplicates)
Partners with claim adjudication vendors ensure proper claims processing and data integrity
Monitor and remediate medical and pharmacy manual data entry errors
Serve as Subject Matter Expert for internal and external stakeholders on medical and pharmacy Copay claim adjudication issues and platform logic variations
Provide ongoing insights on specific program trends and system/process opportunities
Act as the primary point of contact for handling inquiries from prescribers, patients, external clients, and internal program team members
Subject Matter Expert on reviewing and processing of medical claims submitted for copay programs where the therapy is primarily processed through a medical benefit
Ensure proper CMS form and EOB is provided for each eligible item
Validate required elements for payment approval are present
Create manual medical reimbursement record for submission to finance
Review Directive Analytics against Net-Suite and make necessary corrections
Identify applicable programs and guide stakeholders through next steps for patient support
Accept inbound calls, team chats, and emails. Ensure one-call resolution for patients and providers
Communicate status updates across all patient support activities in a holistic, clear, and professional manner
Liaise with program-specific AssistRx resources to secure outcomes and resolve escalations
Maintain accurate documentation and ensure protection of patient and prescriber information
Qualification
Required
High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience
Associate's Degree (AA) or equivalent from a two-year college or technical school, or six months to one year related experience and/or training, or equivalent combination of education and experience
Computer skills required: Contract Management Systems; Microsoft Office
Other skills required: Pharmacy Data Management (PDMI), PNC Card Platform
Benefits
Supportive, progressive, fast-paced environment
Competitive pay structure
Matching 401(k) with immediate vesting
Medical, dental, vision, life, & short-term disability insurance
Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary
Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary
Flexible Culture: Many associates earn the opportunity to work from home after 120 days. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives
Career Growth: We prioritize a "promote from within mentality". We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization
Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible.
If hired, receive a $750 referral bonus!
#TransformingLives Honor: This quarterly award program is a peer to peer honor that recognizes and highlights some of the amazing ways that our team members are transforming lives for patients on a daily basis
Values Award: This quarterly award program recognizes individuals who exhibit one, or many, of our core company values; Excellence, Winning, Respect, Inspiration, and Teamwork
Vision Award: This annual award program recognizes an individual who has gone above and beyond to support the AssistRx vision to transform lives through access to therapy
Company
AssistRx
AssistRx, Inc provides healthcare information technology solutions to the Specialty Pharmaceutical distribution channel.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2024-02-22Acquired
Leadership Team
Edward Hensley
Co-Founder & Chief Commercial Officer
Adam Dresen
Chief Technology Officer | CISO
Recent News
2025-09-30
Company data provided by crunchbase