MGT Patient Access Coordinator

About this role

Why Patients Need You

As the Patient Access Coordinator for Pfizer Primary Care, you will play a critical role in supporting patients’ access to products offered under the Pfizer Primary Care division. Reporting to the Patient Access Director, you will serve as a subject-matter expert in coverage, access, and reimbursement, ensuring patients and healthcare providers receive timely and accurate support throughout the patient’s access journey.

Responsibilities
Coordinate Patient Access: The primary responsibility of the Patient Access Coordinator is to oversee and manage the process of patients gaining access to necessary treatments and resources under Pfizer Primary Care

• This includes coordinating with healthcare providers, HUB, pharmacies, and other stakeholders to ensure patients have access to the medications and services they need

• Conduct benefit investigations and contact payers to research coverage and benefits

Educating Patients: Will be responsible for educating patients on the resources and support available to them, as well as providing information on insurance coverage and financial assistance options

• This may involve conducting patient welcome calls and providing guidance and education on navigating the healthcare system

• Educate Providers Patients on the Prior Authorization Process and Utilization Management Criteria

• Explain the prior authorization, medical exception, and appeals process. Help providers and patients navigate and understand payer policy criteria

Maintain Documentation: It is essential for the Patient Access Coordinator to maintain accurate and up-to-date patient records and documentation related to access to treatments and services in approved CRM

• This includes managing patient files, insurance information, and any other documentation required for access to medications and resources

Collaborate with Healthcare Providers: Work closely with healthcare providers to ensure that patients receive the appropriate treatments and services

• This may involve communicating with physicians, nurses, and other healthcare professionals to gather necessary information and coordinate care plans

Educate on Access Programs: Will be responsible for educating patients on Pfizer patient access programs and identifying any issues or barriers that may prevent patients from receiving necessary treatments

• This may involve conducting research, analyzing data, and making recommendations for improvements to the access process

Provide Support to Patients: Will act as a point of contact for patients, providing support and assistance throughout the access process

• This may include answering questions, addressing concerns, and providing emotional support to patients and their families

• Collaborate with Field Access Leads and HUB Point of Contact: Will work closely with field access leads and HUB Point of Contacts to coordinate follow-up and required actions to ensure access to treatments and services
• This will involve leading access connect calls to gather and review necessary information and coordinate care plans

• Stay Informed on Industry Changes: It is crucial for the Patient Access Coordinator to stay informed on changes in the healthcare industry, including new treatments, insurance policies, and regulations
• This will ensure that patients receive the most up-to-date information and access to the best possible care

• Maintain Confidentiality: The Patient Access Coordinator will be responsible for handling sensitive patient information

• Provide education and support against performance standards with a focus on a positive patient/provider experience

• Collaborate with internal and external functions to execute logistical and transactional activities related to patient access and order/prescription management

• Coordinate with Pfizer colleagues and Patient Support Program/Hub staff to resolve patient access issues.

• Build trust through consistent follow-up and deep knowledge of access pathways.

• Communicate effectively to influence stakeholders without direct authority.

• Link customer insights into approved offerings to address access barriers.

• Participate in monitoring and quality improvement initiatives and training

• Adhere to required business rules, work instructions, and SOPs

• Recommend process and efficiency improvements to enhance workflow and service levels

• Manage engagements using various technology platforms and CRM systems such as POLARIS

Qualifications

• Bachelor's degree in a science or health-related field

• Minimum 10 years of total experience in the healthcare field, including at least 7 years in care coordination/case management/reimbursement

• Experience working with a Field Reimbursement Manager/Patient Coordinator/Nurse Coordinator/Patient Navigator

• Prior experience working with a HUB

• Expertise in reimbursement activities, BI/BV, Prior Authorization, and Appeals Assistance

• Travel 5-10%

Preferred Skills

• Live in the time zone of the assigned geography

• Broad therapeutic area knowledge in primary care and specialty accounts

• Prior experience working in a specialty pharmacy or with payers

• Strong organization

• Excellent written and verbal communication skills.

• Strong relationship-building skills, especially with elderly populations.

• Demonstrated trust, integrity, empathy, and patience.

• Ability to deliver concise and impactful presentations.

• High attention to detail and organizational skills.

• Exceptional critical thinking and ability to explain complex processes.

• Understanding of specialty pharmaceuticals and patient journeys.

• Adherence to regulatory and compliance standards.

• Minimum 2-3 years of medical billing or insurance claim management experience, preferably in the Pharmaceutical/Biopharmaceutical sectors

• Strong collaboration and networking capabilities.

• Team-oriented mindset.

• Understanding of specialty pharmaceuticals and patient journeys.

• Adherence…