Patient Access Specialist

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

Details: The ideal candidate has healthcare call center experience along with verifying IV and pharmacy benefits.

Location: Remote, USA

Shift Hours: Must be available to work any shift during the program hours of 8:00 am - 10:00 pm EST.

PRIMARY DUTIES AND RESPONSIBILITIES:

· Provides advanced services to patients, providers and caregivers. Services could include but not limited to:

• Billing and coding support.
• Claims assistance, tracking and submission.
• Prior authorization assistance and tracking.
• Coordination of benefits.
• Benefit verification result call.
• Welcome calls.
• Advanced alternate coverage research.
• Appeals/Denials.
• Intakes and reports adverse events as directed.

· Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

· Establishes themselves as regional experts regarding payer trends and reports any reimbursement trends/delays to management team (e.g. billing denials, claim denials, pricing errors, payments, etc.).

· Processes any necessary correspondence.

· Coordinates with internal and external service providers to ensure services are performed in accordance with program policy and within expected service level agreements (SLA’s).

· Maintains confidentiality in regards to all patient sensitive information.

· Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action.

· Required to be self-motivated, working from a queue (phone or system). Expected to perform work in accordance with defined standard operating procedures. Management will monitor queues and provide active feedback as required.

· Performs related duties as assigned, which could include well defined services generally performed by other program representatives (e.g. benefit verifications, Patient Assistance Program determinations).

· Applies company policies and procedures to resolve a variety of issues.

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

· High school diploma or GED required.

· Requires a minimum of four (4) years directly related and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration or …