Patient Access Specialist

Description

The Patient Access Specialist is responsible for performing detailed insurance benefit verifications while maintaining effective communication and attention to detail. This role is a part of the Customer Operations Department.

The Patient Access Specialist is based either on-site in a Kerecis office or, in areas where Kerecis does not have a location, in a home office. The role reports to the Patient Access Specialist Manager.

Essential Functions

• Protect confidential patient health information (PHI) at all stages of the verification of benefits process
• Verify medical benefits for patients seeking treatment with Kerecis products including detailed review of patient responsibility for Kerecis treatment
• Verify authorization requirements and initiate prior authorizations while considering payer coverage criteria information
• Prepare and send insurance benefit verification results to healthcare providers on deadline
• Report and resolve any payer delays/challenges and/or escalated complaints
• Collaborate with Market Access and Reimbursement teams
• Maintain an elevated quality of work to facilitate improved access of treatment for patients in need
• Other tasks and responsibilities as assigned

Requirements

Competencies & Attributes

• Strong verbal and written communication skills
• Passionate about providing patients with access to care
• Ability to work on a team aiming for collective success
• Ability to work independently and problem solve
• Knowledge of medical terminology
• Working understanding of medical insurance

Education & Experience

• Highschool diploma or equivalent required, bachelor’s degree preferred
• Min 1 year working with prior authorization/insurance verifications preferred

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time. Kerecis is an equal opportunity employer.