Patient Access Specialist

Description:

The Patient Access Specialist is responsible for various functions in support of patient access to the SPRINT PNS System including but not limited to collaborating with payers, providers, patients, field sales representatives and other functional areas within the company. Through our SPRcare Patient Access Program, the Patient Access Specialist will provide exceptional support to internal and external customers, verify benefits and eligibility, collect supportive clinical documentation for the facilitation of authorizations and/or pre-service appeals, and process decisions from payers.

Responsiblities

Provide superior customer support to external customers, patient candidates, and the internal SPR Sales Organization
Verify medical benefits and facilitate authorization process fulfilling payer requirements to enable access to treatment
Facilitate pre-service appeal requests for commercial insurance companies, government payers, workers compensation, and liability insurance for coverage of SPRINT PNS
Follow-up and track all requests to insurance companies
Provide frequent and on-going communications to providers, patients, payers, and internal teams
Coordinate with providers and patients to obtain appropriate authorizations and necessary documentation related to the patient access process
Assist in identifying and analyzing payer trends/issues impacting patient and market access
Maintain precise documentation in databases and files
Perform other duties and projects as assigned by management
Requirements:
A minimum of 4 years' experience in health insurance, coding, coverage, billing, and reimbursement, and verification of benefits for Medicare, Medicaid, and Commercial payers
Knowledge of medical benefits, insurance standards, investigation processes, and compliance requirements for reimbursement for Medicare, Medicaid, Commercial, Workers Compensation, and liability insurances
Knowledge of HIPAA and related patient privacy laws
Proficiency in Microsoft Office Software, email programs, and online information systems
Medical Device experience preferred
Customer Service and/or Call Center experience a plus
Experience working in a CRM platform, ideally Salesforce, preferred

Working Conditions

Ability and willingness to "get the job done", allowing for flexible and extended hours, depending upon the project needs
Small office environment (does own documentation and interacts directly with others in virtually all situations)
Travel - less than 10%

Why Join Our Team?

Voted Top Workplace
Competitive salary with company-paid medical, dental, and vision benefits
High growth company with game changing technology
A passion for improving the lives of millions of pain sufferers