Patient Services Specialist
Cary, NC Cary, NC Full-time Contract Full-time Contract Up to $19 an hour Up to $19 an hour 6 days ago 6 days ago 6 days ago CLIENT Overview:
Our client, a Global Fortune 50 organization and one of the world's largest distributors of healthcare systems, medical supplies & pharmaceutical products.
JOB Overview:
JOB TITLE:
Patient Services Specialist LOCATION:
Cary NC DURATION:
3 Month temp to perm PAY RATE:
$19.
00/hr.
This position operates within a professional office environment, requiring availability between 8:
00 am and 8:
00 pm Eastern Time.
The Reimbursement Customer Service Representative 3, also known as the Patient Services Specialist, operates within a dynamic, high-volume contact center setting to offer specialized access and reimbursement support to patients, healthcare providers, and manufacturer representatives.
This role frequently engages with commercial payers via telephone to conduct thorough benefits verifications.
It requires consistent collaboration with commercial payers to ensure accurate coverage and reimbursement across various therapeutic domains.
Proficiency in insurance plan structures is essential to acquire comprehensive benefit details and optimize plan advantages.
The role also encompasses the acquisition of payer-specific prior authorization processes and documentation prerequisites, subsequently communicating the results of benefits verification to healthcare providers and patients.
A foundational understanding of Medicare and Medicaid programs is desirable.
KEY
Responsibilities:
Communicate with payers to validate patient eligibility and furnish product-specific coverage insights.
Assist patients and physicians in navigating prior authorization, managing appeals, providing nurse training, and overseeing home health administration.
Interface with physicians, patients, and manufacturer representatives to secure drug-specific coverage information.
Offer assistance and screening for patient assistance programs and co-pay offerings.
Conduct research to identify suitable alternative funding sources and offer recommendations to patients accordingly.
Provide accurate and punctual follow-up for all reimbursement inquiries, aligning with program guidelines.
Ensure precise and comprehensive entry of intake information to facilitate thorough reimbursement research.
Compile payer-specific information for the reimbursement database through diligent research.
Undertake end-to-end processing of new referrals and re-enrollments.
Adhere to the program's outreach schedule for patients and healthcare providers to ensure timely commencement of therapy.
Facilitate healthcare provider credentialing for online portal access by HCPs and office staff.
JOB REQUIREMENTS:
Minimum Requirements:
High School diploma or equivalent.
2
years of customer service experience in a healthcare setting.
2
years of experience in Medical Claims or insurance operations.
Critical Skills:
Prior experience in the healthcare industry, encompassing aspects such as insurance verification, claim adjudication, outpatient billing, pharmaceutical manufacturing, or physician's office operations.
Proficiency in composing and documenting outcomes of benefit investigations and presenting regular written status reports to management.
Capability to manage multiple systems and take ownership of patient cases to ensure timely completion of process steps.
Preferred familiarity with CPR
system.
Additional Knowledge/Skills:
Experience with ICD-10, HCPCS, and CPT coding.
Adeptness in managing multiple priorities within a dynamic environment.
Strong verbal and written communication skills for effective interaction with colleagues, insurance carriers, patients, and medical personnel.
Exceptional organizational skills.
Proficiency in MS Office suite.
Problem-solving and decision-making acumen.
Education:
High School Diploma or equivalent.
Note:
Candidates that are offered a position are required to pass pre-employment drug and background screening.
AKASH DEVGAN Job Types:
Full-time, Contract Salary:
Up to $19.
00 per hour Expected hours:
40 per week
Benefits:
Health insurance Schedule:
8 hour shift Monday to Friday Work setting:
In-person Office Ability to commute/relocate:
Cary, NC 27513:
Reliably commute or planning to relocate before starting work (Required) Education:
High school or equivalent (Required)
Experience:
Customer service:
2 years (Required) Healthcare Industry:
2 years (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
Our client, a Global Fortune 50 organization and one of the world's largest distributors of healthcare systems, medical supplies & pharmaceutical products.
JOB Overview:
JOB TITLE:
Patient Services Specialist LOCATION:
Cary NC DURATION:
3 Month temp to perm PAY RATE:
$19.
00/hr.
This position operates within a professional office environment, requiring availability between 8:
00 am and 8:
00 pm Eastern Time.
The Reimbursement Customer Service Representative 3, also known as the Patient Services Specialist, operates within a dynamic, high-volume contact center setting to offer specialized access and reimbursement support to patients, healthcare providers, and manufacturer representatives.
This role frequently engages with commercial payers via telephone to conduct thorough benefits verifications.
It requires consistent collaboration with commercial payers to ensure accurate coverage and reimbursement across various therapeutic domains.
Proficiency in insurance plan structures is essential to acquire comprehensive benefit details and optimize plan advantages.
The role also encompasses the acquisition of payer-specific prior authorization processes and documentation prerequisites, subsequently communicating the results of benefits verification to healthcare providers and patients.
A foundational understanding of Medicare and Medicaid programs is desirable.
KEY
Responsibilities:
Communicate with payers to validate patient eligibility and furnish product-specific coverage insights.
Assist patients and physicians in navigating prior authorization, managing appeals, providing nurse training, and overseeing home health administration.
Interface with physicians, patients, and manufacturer representatives to secure drug-specific coverage information.
Offer assistance and screening for patient assistance programs and co-pay offerings.
Conduct research to identify suitable alternative funding sources and offer recommendations to patients accordingly.
Provide accurate and punctual follow-up for all reimbursement inquiries, aligning with program guidelines.
Ensure precise and comprehensive entry of intake information to facilitate thorough reimbursement research.
Compile payer-specific information for the reimbursement database through diligent research.
Undertake end-to-end processing of new referrals and re-enrollments.
Adhere to the program's outreach schedule for patients and healthcare providers to ensure timely commencement of therapy.
Facilitate healthcare provider credentialing for online portal access by HCPs and office staff.
JOB REQUIREMENTS:
Minimum Requirements:
High School diploma or equivalent.
2
years of customer service experience in a healthcare setting.
2
years of experience in Medical Claims or insurance operations.
Critical Skills:
Prior experience in the healthcare industry, encompassing aspects such as insurance verification, claim adjudication, outpatient billing, pharmaceutical manufacturing, or physician's office operations.
Proficiency in composing and documenting outcomes of benefit investigations and presenting regular written status reports to management.
Capability to manage multiple systems and take ownership of patient cases to ensure timely completion of process steps.
Preferred familiarity with CPR
system.
Additional Knowledge/Skills:
Experience with ICD-10, HCPCS, and CPT coding.
Adeptness in managing multiple priorities within a dynamic environment.
Strong verbal and written communication skills for effective interaction with colleagues, insurance carriers, patients, and medical personnel.
Exceptional organizational skills.
Proficiency in MS Office suite.
Problem-solving and decision-making acumen.
Education:
High School Diploma or equivalent.
Note:
Candidates that are offered a position are required to pass pre-employment drug and background screening.
AKASH DEVGAN Job Types:
Full-time, Contract Salary:
Up to $19.
00 per hour Expected hours:
40 per week
Benefits:
Health insurance Schedule:
8 hour shift Monday to Friday Work setting:
In-person Office Ability to commute/relocate:
Cary, NC 27513:
Reliably commute or planning to relocate before starting work (Required) Education:
High school or equivalent (Required)
Experience:
Customer service:
2 years (Required) Healthcare Industry:
2 years (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
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