● Conduct thorough eligibility and benefits assessments for patients, collaborating with commercial and governmental insurance companies and pharmacy benefits payers.● Utilize electronic data management systems (EDMS) such as Salesforce to update status reports, logs, and project tracking data, ensuring accuracy and compliance.● Facilitate benefit investigations, specializing in neuroscience medications, and adeptly handle day-to-day activities adhering to regulatory protocols and guidelines.

Description● Verified patient eligibility with commercial insurance companies and pharmacy benefits payers, ensuring adherence to regulatory standards.● Provided expert support for prior authorizations and appeals related to immunology medications. Facilitate submission of necessary documentation for payer/plan review.● Cultivated strong relationships with healthcare providers, promoting trust and collaboration.

● Acted as primary point of contact for various stakeholders including payers, patients, caregivers, specialty pharmacies, and providers, delivering inbound and outbound phone support.● Performed outreach to gather missing information from sites, patients, and field representatives, ensuring comprehensive case resolution.● Facilitated collaborative processes to coordinate patient benefits, product orders, and appointment scheduling. Monitored and tracked benefit investigations and prior authorization cases.● Utilized Salesforce for end-to-end case management, maintaining accurate reporting and escalating complex cases per standard operating procedures (SOPs).

● Compiled, submitted, and obtained approval of submission documents to Institutional Review Boards (IRB), facilitating the regulatory approval process for clinical trials.● Prepared and reviewed site regulatory documents for clinical trials, ensuring completeness and accuracy while adhering to regulatory standards.● Tracked and monitored progress, approvals, and execution of regulatory documents, including ethics, Informed Consent Forms (ICF), and Investigator Pack (IP) release documents, in alignment with project timelines.● Performed data entry and management in Electronic Data Management Systems (EDMS), maintaining accurate and organized records of regulatory documentation.

● Conducted redeterminations and adjustments for Adult Medicaid program recipients, ensuring compliance with program guidelines and regulations.● Interviewed clients and collateral contacts to gather relevant medical, work, and income history, assessing eligibility based on gathered information.