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Senior Buyer
4 weeks ago
The Patient Access Specialist III (PASIII) will be responsible for performing all the functions needed to complete prior authorizations (PAs) that are escalated and are unable to be completed by Patient Access Specialist I. The PASIII will work closely with members of the Patient Access, Revenue Cycle Management, and Clinical Services Departments.
Job Responsibilities:
Initiate all PAs
Follow up on all unresolved PAs on days 7 and 14.
Check the department email for requests and resolutions.
Ensure patient charts are updated and the PA status is accurately assigned/identified and communicated to all parties.
Escalate un-resolved/open PA issues to Patient Access Lead.
Assist clinics and patients in GAP exception processes.
Regularly collaborate with Clinical Services, RCM, and other members of the Patient Access team to support their functions related to benefit verification, prior authorizations, and other requirements.
Always comply with HIPPA and all other applicable regulations as well as CND's policies.
In the absence of PAS I or PAS II, assist with PAS I or PAS II related duties.
Other duties as assigned.
Knowledge, Skills & Experience:
3-5 years' experience completing BVs, PAs and other pre-authorizations as well as medical billing
Always act in a highly compliant and professional manner.
Understand and apply knowledge of the U.S. healthcare system as well as government and commercial U.S. health insurance and coverage.
Understand and apply knowledge of medical front office processes and terminology.
High attention to detail and highly accurate documentation of information.
Strong customer service skills to be used in internal communications with the RCM and Clinical Services teams.
Strong analytical skills to organize data, interpret data and to enable problem solving.
Excellent poise and professionalism in verbal and written communication.
Strong ability to work effectively in fast-paced, dynamic team environments.
Excellent time management.
Strong ability to multitask.
Education, Certifications & Licensures:
High school diploma or GED certificate required.
Associate degree preferred.
Other:
Ability to use computers, software, and related platforms.
Must possess the ability to sit or stand for long periods
This position is fully remote with the possibility of travel between CND's Scottsdale, AZ or Atlanta, GA offices a couple times per year.
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