Rare Disease Coverage & Access Coordinator
Location: Gilbert, AZ Onsite / Remote / Hybrid options available
Reports To: Coverage & Access Manager
Compensation Plan: $25-27+/hr plus health benefits package, 401k plan, professional development, and more About the Role
A growing national specialty pharmacy organization is seeking a Coverage & Access Coordinator to support patients living with rare diseases. This role is critical in helping patients obtain life-changing medications by navigating insurance benefits, prior authorizations, and financial assistance programs. If you have experience in specialty pharmacy reimbursement, benefit investigations, or prior authorization processing and want to make a meaningful impact, this is an excellent opportunity to join a mission-driven, patient focused team. What You’ll Do
- Conduct detailed rare disease insurance benefit investigations to determine coverage, copays, and patient responsibility
- Process and adjudicate prescription claims, resolving rejections and coverage issues
- Prepare and submit prior authorizations and appeals , following up to ensure timely approvals
- Partner with patients, providers, and payers to overcome access barriers
- Identify and coordinate financial assistance options (copay cards, foundations, PAPs)
- Communicate claim status updates clearly to patients and healthcare teams
- Maintain accurate documentation of benefits, interactions, and resolutions
- Stay current on insurance policies, formularies, and reimbursement requirements
- Collaborate with pharmacists, patient care teams, and internal stakeholders to ensure seamless service
- High school diploma or equivalent
- Must be 18 years of age or older
- 2+ years of experience in one or more of the following:
- Pharmacy benefit investigation
- Prior authorization processing
- Reimbursement support
- Specialty pharmacy or healthcare access services
- Solid understanding of:
- Insurance plans and Pharmacy Benefit Managers (PBMs)
- Medical vs. pharmacy benefit structures
- Claim adjudication and appeals processes
- Strong attention to detail and problem-solving skills
- Excellent communication and customer service abilities
- Proficiency with computers and basic office software
- Experience supporting rare disease or specialty medications
- Knowledge of Medicare, Medicaid, and commercial insurance policies
- Familiarity with electronic prior authorization (ePA) platforms
- Certified Pharmacy Technician (CPhT)
- Bilingual language skills
- Daily use of phone systems, computers, and pharmacy software
- Microsoft Office (Word, Excel) and related applications
- Patient-focused specialty pharmacy workflow
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