Provide market access support to customers through prior authorization, appeals support, detailed claims review and reimbursement hotline support. 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 is responsible for providing excellent customer service and follow-up on all assigned work. The Specialist is also expected to meet quality metrics to ensure quality service to all customer types.
Compass Consulting Experience:
- 5+ years medical billing or prior authorization experience.
- Technical Certificate in Patient Access CHAA Certification.
- 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.
- 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, multitask and prioritize workflows.
- Assisted with insurance eligibility verification and advised non-insured patients of insurance enrollment and sliding scale fees.
- Handled patient prescription requests and coordinated with pharmacies, nurses, and Primary Care Physicians regarding medical care.
- Ordered interpretive services and interfaced with outside agencies regarding patient services and accounts.
- Organized, prioritized, and coordinated tasks using multi-line phone system in an efficient and timely manner.
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