- Customer service for overflow help with ACES.
- Updating information in accounts from Med Billers and ACES
- Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
- Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
- Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
- Identify any coverage restrictions and details on how to expedite patient access
- Document and initiate prior authorization process and claims appeals
- Report any reimbursement trends or delays in coverage to management
- Data Entry
- Experience working with databases (CRM preferable) or a tracking system; Salesforce CRM experience preferred
- Experience working in a health care/pharmaceutical industry environment preferred
- Understanding of challenges associated with patients medical condition preferred
- Previous work experience in Specialty Pharmacy or Customer Service preferred
- Experience working with people in situations that are high-pressure and time-sensitive (either telephone or face-to-face), and that involve solving problems, making decisions, using excellent judgment and customer service skills. This can be obtained through a combination of work experience and post high school education and need not be obtained in a traditional customer service setting.
- Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications, and keyboarding skills.
- Strong ability to multi-task and strong time management skills
- Ability to function in a high-volume, fast-paced environment.
- Dependable and strong work ethic
- Ability to accept and implement feedback and coaching Specific type of experience preferred
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patient access specialist - Orlando, FL , USA, United States - The Staffing Resource Group Inc
Description
Patient Access SpecialistExciting opportunity with new openings
Job Scope:
The purpose of this position is to help patients get access to the medications and therapies that they need. This role works directly with healthcare providers & insurance plans/payers to gather information about a patient s insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications.
Title: Patient Access Specialist
Planned Start Date: 04/29/2024.
Industry: Specialty Pharmacy Care
Work Location: Orlando, FL
Pay: Up to $22.00hr Pay
Shift Options: M-F 8AM-5PM, 9AM-6PM, 10AM-7PM, 11AM-8PM (1 hour lunch)
Training Work Hours: M-F 9:30am-5pm (1 hour paid lunch) for 4 weeks. Post training schedules will begin after 4 weeks of training.
Retention Bonus Potential: $500 retention bonus once they are employed to 7/31/24.
Length of assignment: Temp to hire. If performance & attendance are met, perm role could be offered.
Responsibilities:
EOE/AOE
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