Patient Access Specialist

Location: Remote, USA

Work Hours/Shifts Available:

• 9:30am - 6:30pm EST
• 11:00am - 8:00pm EST

Under the general supervision of an Operations Manager, the Patient Access Specialist will be providing advanced services to patients, providers, and caregivers on behalf of patients for a specific manufacturer sponsored program or set of programs.

1. 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.
• Prior Authorization submission to the payer
• Coordination of benefits.
• Benefit verification payer calls
• Welcome calls.
• Advanced alternate coverage research.
• Appeals/Denials.
• Intakes and reports adverse events as directed.
• In bound and outbound calls.

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

3. 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.).

4. Processes any necessary correspondence.

5. 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).

6. Maintains confidentiality regarding all patient sensitive information.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. 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).

13. 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 similar vocations.
• A Bachelor's degree is preferred.
• An equivalent combination of education and experience will be considered.

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

• Advanced customer service experience.
• Ability to communicate effectively both orally and in writing.
• Ability to build productive internal/external working relationships.
• Advanced interpersonal skills.
• Basic analytical skills.
• Advanced organizational skills and attention to detail.
• Must be proficient with Microsoft Excel, Outlook and Word.
• General knowledge of the healthcare industry is preferred.

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave.

To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

For details, visit https://www.virtualfairhub.com/amerisourcebergen

*This Salary Range reflects a National Average for this job. The actual range may vary based on your locale. Ranges in Colorado/California/Washington/New York State-specific locations may be up to 10% lower than the minimum salary range, and 12% higher than the maximum salary range.

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@amerisourcebergen.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned