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Patient Access Consultant - Remote

  • Location: United States of America
  • Job Type:Contract

Posted 28 days ago

  • Expiry Date: 17 August 2022
  • Referral:

Job Description:

  • Under the general supervision of an Operations Manager, they are considered a master of our services including but not limited to reimbursement activities, claim submission, claim status, collection activity, appeals, patient assistance, and copay assistance.

  • On a day-to-day basis they may be in contact with various customers of our services including but not limited to patients, providers, caregivers, and client brand teams.

Roles and Responsibilities:

  • Master of all standard and advanced services and willing to perform them as needed for the good of our patients.

  • Including 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

  • Inbound Phone Queue/General Program Inquiries

  • Determination for support programs (Copay, PAP, Medicaid, etc.)

  • Pharmacy triage and coordination

  • Order processing for wholesale orders

  • Other follow-up activities (missing info, prior authorization, etc.)

  • Intakes and reports adverse events as directed.

  • Non-Clinical adherence services

  • Engages with manufacturer representatives around items like payer profiles, reimbursement trends, issues with specific offices, etc.

  • Responsible for coordination of services with field reimbursement teams and sales representatives.

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

  • Independently analyzes, reports, resolves, and communicates any reimbursement trends/delays (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

  • Provides training and support to internal associates.

  • Fields questions from program representatives and specialists.

  • Handles initial customer escalations.

  • Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate.

  • Independently and effectively resolves complex accounts with minimal supervision.

  • Maintains confidentiality in regard to all patient-sensitive information.

  • Works on complex issues where analysis of situations or data requires an in-depth evaluation of variable factors. Exercises judgment in selecting methods, techniques, and evaluation criteria for obtaining results. Networks with key contacts outside their own area of expertise.

  • Acts independently to determine methods and procedures on new or special assignments.

  • Performs related duties and special projects as assigned. 

Must-Have Skills:

  • Ability to communicate effectively both orally and in writing.

  • Ability to build productive internal/external working relationships.

  • Advanced interpersonal skills.

  • Strong mathematical skills.

  • Basic analytical skills.

  • Advanced organizational skills and attention to detail.

  • Extensive knowledge of pharmacy operations and medical claims.

  • Excellent use of medical industry vernacular.

  • General knowledge of health care billing is required. Advanced knowledge is preferred.

  • Advanced use of MS Excel, Outlook, and Word.

  • Developing professional expertise; applying company policies and procedures to resolve a variety of issues.

Educational Requirements:

  • A high school diploma or GED is required.

  • Requires broad training in fields such as business administration, accounting, computer sciences, medical billing and coding, customer service, or similar vocations generally obtained through completion of a two-year associate’s degree program, technical vocational training, or equivalent combination of experience and education.

  • Five years (5) + years of directly related and progressively responsible experience required.

  • A two-year degree can be used in lieu of 2 years of the experience requirement, and a four-year degree in lieu of 4 years of experience.

  • Four-year degree preferred.

About ASK: ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities.

ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.