The Patient Access Case Manager is responsible for Intracept Patient Access support and for managing the authorization process for the Intracept Procedure. Providing customer and facility training related to Intracept Patient Access Portal, customer account set-up, authorization and appeals process with transparent communications with both internal and external customers.
Essential Responsibilities / Functions:
- Set up new accounts in portal, train and re-educate as needed.
- Confirm case information is complete, verify benefits and instructions for case submission, submit each patient case to payer in a timely and accurate manner.
- Communicate clearly with Internal and External customers related to patient access for the Intracept Procedure, including but not limited to case status, needed information, TM involvement, reporting etc.
- Monitor self-funded plans and forward to director as opportunities arise.
- Monitor and re-engage payer until determination – if denied submit to next level until appeal rights are exhausted.
- Manage and monitor payer trends as it relates to approvals/denials.
- Perform monthly reviews with each office coordinator, TM and sales organization.
- Provided additional reports to sales organization and Relievant leadership as needed.
- Physician specific LOMN templates have been designed – prepare LOMN templates on each case
- Minimum 2 years medical Insurance authorization experience preferred, minimum 1-year patient access/reimbursement experience preferred.
- Clear understanding and ability to navigate the prior authorization and appeals process with commercial payers.
- Understand technology assessment process for payer environment.
- Exemplify ability to think strategically, follow processes, set and manage priorities, manage multiple projects and allocate and reallocate resources as required.
- Ability to work within multiple software systems.
- Strength in using resourcefulness to identify data and information which will increase product knowledge, drive strategic decisions, and bring increased value to customers (internal and external).
- Quick adaptation and successful interaction with people/teams as the needs of the business change or evolve.
- Must be willing to travel at least as needed, 10%.
- Excellent verbal and written communication skills.
- Excellent interpersonal skills.
- Strong presentation skills.
- BS/BA Degree Required.
- Certified in Outpatient Coding (COC) preferred.
We are proud to offer our employees an excellent compensation and benefits package and we are an equal opportunity employer.
For more information or to apply, please contact email@example.com.