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Patient Services Specialist

Cary, NC

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Description

RemX is accepting applications for an experienced Patient Services Specialist for an amazing temp to hire opportunity in Cary NC! 

Key Responsibilities

  1. Contact payers to verify patient eligibility and product specific coverage information. 
  2. Assist patients and physicians with prior authorization,appeal management,nurse training, and home health administration.
  3. Interface with physicians, patients, and manufacturer representatives to obtain and provide drug specific coverage information.
  4. Provide support and screening for patient assistance program and co-pay offerings.
  5. Conduct research to identify appropriate alternate funding sources and make recommendation.
  6. Provide accurate and timely follow-up to all reimbursement inquires in accordance with program guidelines.
  7. Ensure that the intake information is entered accurately and completely in order to perform all reimbursement research.
  8. Research and compile payer specific information for reimbursement database.
  9. Complete end to end processing of new referrals and re-enrollments.
  10. Follow program cadence for outreach to patients and health care providers to ensure patient can start therapy on time.
  11. Complete healthcare provider's credentialing for online portal access to HCP and office staff.

 

Job Requirements

Minimum Requirements

  • High School diploma or equivalent.
  • 2+ years’ customer service experience within a healthcare environment.
  • 2+ Medical Claims or insurance experience.
  • Experience in the healthcare industry including, but not limited to, insurance verification and/or claim adjudication, physician’s office or outpatient billing, pharmacy and/or pharmaceutical manufacturers.
  • Must be able to compose and document benefit investigation outcomes and prepare written status reports to management on a regular basis.
  • Ability to work on multiple systems and take ownership of patient cases to ensure timely completion of all required steps in the process.
  • CPR+ system knowledge preferred. 
  • Associates degree is preferred.
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