Atlantadiabetes
Patient Access Representative
Job Location: In person
Duties
Obtains information necessary to complete the prior authorization.
Completes the prior authorization process for multiple providers — submits required documentation, tracks status of requests, schedules patients when approval received.
Responsible for contacting patients and pharmacies to inform them of outcome or inform patients of medication changes made by physicians and/or providers.
Coordinates with insurer to verify that patient is covered by insurance, coverage limitations, and eligibility for services to be provided, including specialty medications benefit verification and prior authorization for all providers.
Consistently follows up with insurance company on the status of prior authorizations for medications and medical devices.
Develops and maintains relationships with pharmaceutical and medical device representatives.
Responsible for tracking, obtaining, and extending authorizations from various carriers in a timely manner, requesting input from appropriate team members as needed.
Researches and works with staff in resolving and resubmitting denied claims, including a review of timely submission and other processing procedures.
Responds professionally to all inquiries from patients, staff, and payors in a timely manner.
Accurately documents patient accounts of all actions taken.
As necessary, negotiates a work improvement plan with management to raise work quality and quantity to standards.
Completes additional projects and duties as assigned.
Ability to meet established deadlines timely, accurately and with a sense of urgency.
Other duties as assigned/required.
Supervision Work is performed under general supervision from the Department Manager of the Clinical Call Center unit.
Equipment Must be familiar with computer technology and comprehend basic computer functions.
Working Conditions Work is performed in an office, and/or clinic environment.
Required Abilities and Dispositions
High personal motivation, self‑management, and detail‑orientation; ability to take responsibility in meeting deadlines and making progress without direct supervision.
Strong spoken and written communication skills.
Capacity and will to learn new software, device methods, and work routines quickly; flexibility in responding to new department opportunities as they arise.
Motivation to engage in and manage a wide range of intellectual and physical work.
Strong existing computer skills with Microsoft Office statistical software, and general Internet and electronic communications.
Articulate and tactful communication skills; readiness to meet and work directly with clients.
Physical Requirements
Must be able to sit for long periods of time; must have manual dexterity to work computer systems and keyboard — frequently.
Must be able to have face‑to‑face conversation with patients and staff — frequently.
Must be able to lift 25 lbs. — occasionally.
Must be able to stand for a maximum of 30 minutes at a time — occasionally.
Benefits
401(k)
401(k) matching
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance
Schedule
8 hour shift
Day shift
Monday to Friday
No weekends
Overtime
Education High school or equivalent (Preferred).
Job Type Full‑time
Seniority level Entry level
Employment type Full‑time
Job function Other
Industries Medical Practices
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Duties
Obtains information necessary to complete the prior authorization.
Completes the prior authorization process for multiple providers — submits required documentation, tracks status of requests, schedules patients when approval received.
Responsible for contacting patients and pharmacies to inform them of outcome or inform patients of medication changes made by physicians and/or providers.
Coordinates with insurer to verify that patient is covered by insurance, coverage limitations, and eligibility for services to be provided, including specialty medications benefit verification and prior authorization for all providers.
Consistently follows up with insurance company on the status of prior authorizations for medications and medical devices.
Develops and maintains relationships with pharmaceutical and medical device representatives.
Responsible for tracking, obtaining, and extending authorizations from various carriers in a timely manner, requesting input from appropriate team members as needed.
Researches and works with staff in resolving and resubmitting denied claims, including a review of timely submission and other processing procedures.
Responds professionally to all inquiries from patients, staff, and payors in a timely manner.
Accurately documents patient accounts of all actions taken.
As necessary, negotiates a work improvement plan with management to raise work quality and quantity to standards.
Completes additional projects and duties as assigned.
Ability to meet established deadlines timely, accurately and with a sense of urgency.
Other duties as assigned/required.
Supervision Work is performed under general supervision from the Department Manager of the Clinical Call Center unit.
Equipment Must be familiar with computer technology and comprehend basic computer functions.
Working Conditions Work is performed in an office, and/or clinic environment.
Required Abilities and Dispositions
High personal motivation, self‑management, and detail‑orientation; ability to take responsibility in meeting deadlines and making progress without direct supervision.
Strong spoken and written communication skills.
Capacity and will to learn new software, device methods, and work routines quickly; flexibility in responding to new department opportunities as they arise.
Motivation to engage in and manage a wide range of intellectual and physical work.
Strong existing computer skills with Microsoft Office statistical software, and general Internet and electronic communications.
Articulate and tactful communication skills; readiness to meet and work directly with clients.
Physical Requirements
Must be able to sit for long periods of time; must have manual dexterity to work computer systems and keyboard — frequently.
Must be able to have face‑to‑face conversation with patients and staff — frequently.
Must be able to lift 25 lbs. — occasionally.
Must be able to stand for a maximum of 30 minutes at a time — occasionally.
Benefits
401(k)
401(k) matching
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance
Schedule
8 hour shift
Day shift
Monday to Friday
No weekends
Overtime
Education High school or equivalent (Preferred).
Job Type Full‑time
Seniority level Entry level
Employment type Full‑time
Job function Other
Industries Medical Practices
#J-18808-Ljbffr