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Copay Assistance Specialist

4 months ago

Nashville, United States Tennesee Retina Full time
Job DescriptionJob Description

Who We Are 

Tennessee Retina is the largest Ophthalmology practice in middle Tennessee, offering rewarding careers across 8 locations. We are committed to providing the highest level of care to our patients in the most convenient and caring manner. Our physicians are leaders in the research and application of new retina, macula, and vitreous treatments.  

We are seeking an energetic and collaborative Co-pay Assistance Specialist. The ideal candidate is responsible for identifying, obtaining, and submitting all documentation necessary to ensure enrollment or re-enrollment for patients presently or identified as possible candidates for Lucentis/Eylea treatment.  

This exciting opportunity will work closely and be supported by a team of colleagues, strong leadership, and cutting-edge technology A day in the life of a Tennessee Retina employee is filled with learning, growing, creating, hard work, and, most of all, fun 

Tennessee Retina offers a competitive salary based on diverse experiences and backgrounds. 

Benefits Offered 

  • Sign On Bonus, Certification Incentive Bonus, and Length of Service Award Bonus Programs 

  • Continuing Education Program 

  • Transportation Reimbursement Program 

  • Employer-sponsored Medical, Dental, Vision, Critical Illness Coverage, Short-term, Long-Term Disability, & Employee Assistance Program 

  • 401(k) with Generous Employer Match 

  • Health Savings Account (HAS) and Flexible Spending Benefits 

  • Paid Holidays and Paid Vacation 

  • Annual Scrub Uniform Allowance 

  • Employee Referral Award Bonus Program 

  • Succession, Growth, and Mentorship Opportunities  

  • Social Gathering and Team Opportunities 

  • Complete new hire training program to fully support, train, and welcome new hires to the team 

 

Responsibilities 

  • Provide financial counseling services regarding financial assistance for uninsured and underinsured patients presenting a financial need by phone or in person. 

  • Ensures all active patients are screened for eligibility opportunities for Co-Pay and Foundation assistance programs. 

  • Must be able to meet numerous deadlines and complete forms related to the timing of credentialing, provider enrollment, and managed care contracting tasks for multiple care providers. 

  • Records and maintains comprehensive documentation of patient enrollment activities. 

  • Notifies the appropriate department of determinations and outcomes via verbal and written communication. 

  • Obtain information and signatures on financial assistance program applications and route them promptly for optimal financial turnaround. 

  • Answer patient calls and requests promptly and efficiently 

  • Initiates enrollment and ordering of drugs for patients without coverage for assigned clinics. 

  • Properly documents all account activity In Patient Manager and Electronic Medical Record systems, 

  • Communicate with the Authorization Coordinator, clinical staff, and Financial Counselors regarding patient treatment and drug enrollment status. 

  • Obtains absence of coverage notification from the Drug Authorization Coordinator and checks for treatment needs. 

  • Keeps current on all pharmaceutical and community resources for assistance and utilizes programs. 

  • Develops and promotes professional rapport with Pharmaceutical Representatives. 

  • The responsibilities listed are a general overview of the position, and additional duties may be assigned under the direction of the Billing Supervisor and Billing Manager. 

 

Education, Training, and Experience 

  • High School graduate or equivalent 

  • Minimum of one year of insurance verification experience with knowledge of CPT and HCPCS coding  

  • Experience reading and understanding payer eligibility electronic returns. Includes the ability to differentiate between insurance plans, co-pay, deductible, and coinsurance. 

  • Proficient in understanding, reading, and interpreting all contents of the paper and electronic medical charts (ERM) and knowledge of medical terminology. 

  • Practical verbal and written communication skills with patients, physicians, management, employees, and the public. 

  • Excellent Organizational skills, multi-task, and logical thinking  

  • Proficient In utilizing MS Excel to analyze data using basic formulas, pivot tables, and charts. 

  • Knowledge of Microsoft Office (Word, Outlook) and the ability to learn and adapt quickly to new software.  

  • Ability to be proactive, take initiative, and perform well in a fast-paced, high-volume practice.  

  • Basic understanding of eye anatomy, medical terminology, ocular pathology, and eye diseases.  

Confidentiality 

Maintains strict confidentiality regarding protected health information (PHI) and understands and adheres to TNR’s HIPAA privacy and security policies and procedures. 

Typical Physical and Working Demands 

Position requires prolonged walking, sitting, bending, stooping, and stretching. Good eye-hand coordination and manual dexterity are sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required. Employees must have a standard hearing range and eyesight to record, prepare, and communicate appropriate reports. Employees must have a standard hearing range and eyesight to record and prepare paper and MDI chart notes and documents. Must be able to lift and carry up to 15 pounds.