Patient Access SpecialistThe Patient Access Specialist oversees the patient's financial journey from start to finish, including benefits investigation, prior authorization support, and enrollment in financial assistance programs. This role manages inbound and outbound communication with patients, prescriber offices, and third-party providers to clarify medical and pharmacy coverage, benefits, and related inquiries, ensuring all interactions are handled efficiently and courteously. Key responsibilities include resolving complex insurance rejections that require follow-up with patients, providers, and payors; managing the full authorization processprior authorizations, appeals, and medical tier exceptionsby initiating, reviewing, submitting, tracking, and following up on requests. The specialist coordinates enrollment in manufacturer-sponsored assistance programs and other financial support resources, serving as a liaison between patients, healthcare providers, insurance companies, and program sponsors to ensure accurate documentation and timely processing.

Job Responsibility

Confirm patient coverage for pharmacy and medical benefits, including eligibility, co-pays, deductibles, secondary insurance, and network status. Identify and explain available financial assistance programs.

Initiate, complete, and track prior authorizations, medical tier exceptions, and appeals. Prepare documentation, collaborate with providers and payors, and ensure adherence to timelines for approvals and denials.

Submit accurate claims for reimbursement, resolve non-clinical payor rejections (e.g., plan limits, coverage terminations), and address benefit discrepancies between insurance providers.

Collect and submit required documentation for copay cards, patient assistance, and other support programs. Monitor renewals, educate patients and providers on eligibility, and resolve delays or denials.

Act as a liaison among patients, providers, and payors to clarify benefits, coverage, and next steps. Provide empathetic, patient-centered support for those navigating financial or medical challenges.

Maintain accurate records of interactions, outcomes, and program details.

Escalate complex cases to management or program sponsors as needed.

Escalate all concerns of adverse events and product quality concerns to the clinical team.

Ensure compliance with HIPAA regulations and organizational policies.

Crosstrain and provide support in other key functions within the organization where needed.

Participate in post-onboarding training and development as needed to enhance skills and performance.

About WalgreensFounded in 1901, Walgreens proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.