Remote Rn Case Review Jobs in Houston, TX (NOW HIRING)

Bilingual Nurse Patient Access Specialist (RN/LPN)

Position Summary

The Bilingual Nurse Patient Access Specialist serves as the primary point of contact for patients, healthcare providers, and field representatives within a Patient Support Services (PSS) program. This role is responsible for facilitating patient access to therapy by conducting benefit investigations, verifying insurance eligibility, supporting prior authorizations and appeals, and assisting with copay and patient assistance programs. Bilingual Clinical Care Managers may also discuss the patient's disease state and treatment options. Bilingual Nurse Patient Access Specialist support patients throughout their treatment journey while ensuring a high level of service, compliance, and coordination across stakeholders.

Job Responsibilities

• Bilingual - Spanish- ability to easily communicate with patients in Spanish regarding the program services
• Support clinical discussions with patients regarding the disease state and products supported by the program.
• Provide patient education on self-injections or use of injectable devices in accordance with program SOPs
• Serve as the primary point of contact for patients, providers, and stakeholders
• Conduct inbound and outbound calls to support program services
• Perform insurance benefit investigations and verify coverage
• Support prior authorizations and appeals processes
• Assist with copay and patient assistance program enrollment
• Provide ongoing patient support and adherence coordination
• Document all interactions accurately and timely
• Deliver high-quality customer service across communication channels
• Collaborate with field representatives and internal teams
• Manage patient caseloads with timely follow-up
• Ensure compliance with HIPAA and regulatory requirements
• Identify and report adverse events and product complaints
• Troubleshoot issues and escalate as needed
• Maintain knowledge of program policies and processes
• Support onboarding and training of new employees
• Meet quality standards and KPIs
• Perform additional duties as assigned

Schedule

• Available for an 8-hour shift between 8:00 AM - 8:00 PM EST

8:00AM - 5:00 PM9:00 AM - 6:00 PM EST11:00 AM - 8:00 PM EST

• Ability to work varying shifts, including evenings as needed
• Remote role requiring a compliant home workspace

Required Qualifications

• Licensed Practical Nurse or Registered Nurse with 1 year post registration experience; or equivalent of education, training and experience with previous experience providing patients with education on self-injections or use of injectable devices.
• Bilingual- Spanish speaker
• 3-5+ years of experience in medical billing, reimbursement, or insurance verification
• Robust understanding of payer coverage and reimbursement (medical and pharmacy)
• Experience in a contact center or patient support environment
• Proficiency with Microsoft Office and CRM systems
• Strong written and verbal communication skills
• High attention to detail and multitasking ability
• Ability to work independently in a virtual environment
• Problem-solving and solution-oriented mindset
• Knowledge of HIPAA and data privacy requirements
• Must reside in the country where the role is posted

Preferred Qualifications

• Licensed Practical Nurse or Registered Nurse with previous case/care manager experience in the hematology field and/or rare diseases.
• Experience in a Patient Support Services (Hub) environment with focus on rare diseases
• Healthcare or pharmaceutical customer service experience

This role is posted under a market-aligned title to better reflect the scope and candidate profile. The internal title for this position is Clinical Care Manager within PASS.

#LI-CES
#LI-DNP

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more athttps://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $62,000 - $104,000 annually. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.