Patient Services Specialist

Interested in a new Patient Services Specialist role? Submit your resume to Requests@CompassCGroup.com today!

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Bay Area Patient Services Specialist Opportunity

 

Reporting to the Reimbursement Operations Manager, the Patient Access Specialist will focus on providing market access support to customers through prior authorization, appeals support and reimbursement hotline support. The Patient Access Specialist will be responsible for providing reimbursement expertise and support regarding all phases of the prior authorization process, appeals and all related market access activities with all types of customers. The Patient Access Specialist will be responsible for providing excellent customer service and follow-up on all assigned work. The Specialist will also be responsible for meeting quality metrics to ensure quality service to all customer types.

Responsibilities:
  • The Patient Access Specialist will adhere to quality of service through QA, additional training and process improvement.
  • Work in conjunction with the Manager to focus on realistic and achievable turn-around times for all department functions.
  • Meet and/or exceed metrics in designated territory to ensure quality service to all customer types.
  • Provide necessary documentation and follow up in order to support the prior authorization and appeal process as well as provide education to customers regarding payer coverage requirements.
  • In conjunction with other team members, stay current on payer coverage policies and patient requirements for HF10 therapy as well as stay current on impact of health care reform to patient’s access to HF10 therapy.
  • Ensure compliance with company compliance policy, in particular patient confidentiality (HIPAA).
  • Perform other duties as required.
Qualifications:
  • Bachelor’s Degree (health economics, life sciences, public health, public policy, finance, business or marketing disciplines) or equivalent work experience.
  • 5+ years medical billing or prior authorization experience.
  • Experience complying with regulatory requirements and company policy in dealing with the customer and patient confidentiality.
  • Applicable experience in reimbursement support relating to appeals and prior authorizations from a payer, provider or medical device/pharmaceutical industry.

Skills:

  • Ability to work with various teams to accomplish organizational goals.
  • Excellent communication skills, both verbal and written.
  • Analytically focused with a high attention to detail.
  • Ability to follow work processes.
  • Must be courteous, professional and balanced with a tenacious drive in order to assist the customer and team in achieving goals.
  • Able to multitask and prioritize workflows.
  • Excellent organizational and project management skills.
  •  Strong interpersonal skills to influence/negotiate complex decisions and ability to demonstrate leadership as a positive advocate for communicating the mission, objectives and results of the team and build cross-functional relationships.

 

Submit your resume to Requests@CompassCGroup.com today! Or apply directly on our website – Apply Now – Patient Service Specialist