CSI Director Patient Access
1 week ago
CSI Director Patient Access
Location
CSI Plano TX
Additional Location(s)
Employee Type
Employee
Working Hours Per Week
40
Job Description
SUMMARY
The Director of Patient Access will lead the team responsible for obtaining prior authorization, billing, accepting and managing pharmacy payor claims as well as the team responsible for medical payor benefit verifications and prior authorizations.
ESSENTIAL DUTIES AND RESPONSIBILITIES
include the following. Other duties may be assigned as necessary.
- Directly oversee both prescription and medical benefits teams including staffing, training, daily workflow management and other tasks as necessary
- Lead and manage the teams, holding members accountable for their performance while fostering a positive and productive work environment.
- Develop and implement reimbursement strategies that maximize revenue and ensure timely payment from payers, including private insurance, Medicare, and Medicaid.
- Oversee the management of the prior authorization process, ensuring efficient and effective handling to facilitate patient access to medications.
- Collaborate with cross-functional teams, including pharmacy operations, clinical services, and patient support, to optimize reimbursement processes and enhance patient care.
- Stay abreast of changes in reimbursement policies and regulations, ensuring compliance and adapting strategies as necessary.
- Utilize knowledge of payor portals and other relevant platforms to streamline processes and improve patient access to medications.
- Contribute to the maintenance and enhancement of CSI Pharmacy's culture of service, ensuring that all activities align with our core values and mission.
- Consistently represents the company in a professional manner.
- Maintains effective working relationships and cooperates with Company personnel.
- Adheres to the Company's compliance requirements as stated in the policy and procedure manual and all other related policies.
- All other projects and tasks as assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Provide the highest level of professionalism, responsiveness, and communication in order to build and maintain a high performing team that works together to achieve results.
- Must possess the ability to multi-task and frequently change direction.
- Must be able to effective lead a high performing team, maintain and increase the high standards of service at CSI Pharmacy while promoting team cohesiveness and a culture of service to each other and our patients.
- Must be able to stay laser focused on the mission of taking the best care of patients possible and willing to what is necessary to achieve this goal.
- Must not only be open to critical feedback but willing and able to give such feedback to their team in a spirit of building each member of the team into the best version of themselves.
- Preferred, but not required, Bachelor's degree in Healthcare Administration, Business, Pharmacy, or related field.
- At least 5 years of experience in home infusion and/or specialty pharmacy (including IVIG/SCIG) reimbursement, both PBM and medical.
- At least 3 years of management experience, with a proven track record of leading teams to achieve results.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.
COMMENTS
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.
NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
By supplying your phone number, you agree to receive communication via phone or text.
CSI Pharmacy is an Equal Opportunity Employer
-
Plano, Texas, United States CSI Pharmacy Full timeJob SummaryWe are seeking a highly skilled Benefits Specialist to join our team at CSI Pharmacy. This role is responsible for performing benefit investigations, obtaining prior authorizations, and ensuring timely processing of patient prescription orders. The ideal candidate will possess excellent customer service skills, analytical and problem-solving...
-
Referral Coordinator
4 months ago
PLANO, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
-
Referral Coordinator
2 weeks ago
Plano, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
-
Referral Coordinator
2 weeks ago
Plano, United States CSI Pharmacy Full timeS UMMARY CSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status...
-
Referral Coordinator
4 months ago
Plano, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
-
Referral Coordinator
2 weeks ago
Plano, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
-
Referral Coordinator
4 months ago
Plano, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
-
Referral Coordinator
3 weeks ago
PLANO, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
-
Data Scientist
2 months ago
Plano, United States CSI Pharmacy Full timeJob DescriptionMust live in Dallas, Ft Worth or Plano area to be considered. Compensation: Starting at 100K - Based on experience.SummaryCSI Pharmacy is seeking a highly skilled and motivated Data Scientist to join our dynamic team. This role will be integral in driving data-driven decision-making across the organization. The Data Scientist will focus on...
-
Data Scientist
4 weeks ago
Plano, United States CSI Pharmacy Full timeMust live in Dallas, Ft Worth or Plano area to be considered. Compensation: Starting at 100K - Based on experience.SummaryCSI Pharmacy is seeking a highly skilled and motivated Data Scientist to join our dynamic team. This role will be integral in driving data-driven decision-making across the organization. The Data Scientist will focus on creating insights...
-
Data Scientist
1 month ago
Plano, United States CSI Pharmacy Full timeMust live in Dallas, Ft Worth or Plano area to be considered. Compensation: Starting at 100K - Based on experience.SummaryCSI Pharmacy is seeking a highly skilled and motivated Data Scientist to join our dynamic team. This role will be integral in driving data-driven decision-making across the organization. The Data Scientist will focus on creating insights...
-
Patient Access Specialist
5 months ago
Plano, United States The LaSalle Group Full timeLaSalle Network has partnered with a healthcare provider in Plano, TX searching for an entry-level Patient Access Specialist to join their team. As a Patient Access Specialist, you will play a vital role in ensuring seamless patient experiences by facilitating the registration process, verifying insurance information and coordinating patient appointments....
-
Medical Insurance Benefits Specialist
1 month ago
Plano, United States CSI Pharmacy Full timeCompensation: $18.00 - $23.00 (based on location), plus benefits and 401KSummaryThe Medical Insurance Benefits Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients,...
-
Medical Benefits Coordinator
3 weeks ago
PLANO, United States CSI Pharmacy Full timeCompensation: $18.00 - $23.00 (based on location), plus benefits and 401KSummaryThe Medical Insurance Benefits Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients,...
-
Medical Benefits Coordinator
2 weeks ago
Plano, United States CSI Pharmacy Full timeCompensation: $18.00 - $23.00 (based on location), plus benefits and 401K Summary The Medical Insurance Benefits Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients,...
-
Medical Benefits Coordinator
2 weeks ago
Plano, United States CSI Pharmacy Full timeCompensation: $18.00 - $23.00 (based on location), plus benefits and 401K Summary The Medical Insurance Benefits Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients,...
-
Medical Insurance Benefits Specialist
1 month ago
Plano, United States CSI Pharmacy Full timeCompensation: $18.00 - $23.00 (based on location), plus benefits and 401KSummaryThe Medical Insurance Benefits Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients,...
-
Medical Insurance Benefits Specialist
2 months ago
Plano, United States CSI Pharmacy Full timeJob DescriptionCompensation: $18.00 - $23.00 (based on location), plus benefits and 401KSummaryThe Medical Insurance Benefits Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service...
-
Referral Coordinator
4 months ago
Plano, TX, United States CSI Pharmacy Full timeS UMMARY CSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status...
-
Referral Coordinator
3 weeks ago
Plano, TX, United States CSI Pharmacy Full timeSUMMARYCSI's Pharmacy's Referral Coordinators are CSI's customer service reps for all new referrals. A Referral Coordinator is in charge of contacting each new referral and coordinating/ managing all pieces of the puzzle to bring a patient on service such as confirming demographics and medical history, confirming and updating patient on insurance status and...
