Patient Therapy Access Specialist

3 days ago

Plano, Texas, United States Abbott Laboratories Full time

About Abbott Laboratories

Abbott Laboratories is a leading global healthcare company that develops and manufactures innovative medical devices, diagnostics, and pharmaceuticals. Our mission is to help people live more fully at all stages of life.

Job Summary

We are seeking a highly skilled Patient Therapy Access Specialist to join our team. As a Patient Therapy Access Specialist, you will be responsible for facilitating and assisting patients with the pre-certification, determination, and authorization process necessary for various medical procedures or therapies based on physician recommendations.

Key Responsibilities

  • Manage multiple cases simultaneously within specific time frames.
  • Follow all policies and procedures related to performing the job role, adhering to all data use, storage, and privacy policies as outlined by Abbott Laboratories.
  • Verify benefits and complete authorization requests promptly.
  • Timely follow up for requested authorizations.
  • Audit required clinical documents for completeness and accuracy.
  • Obtain authorization for the facility, equipment, and physician to perform various procedures from the insurance carrier.
  • Work with key provider contacts to obtain required clinical information for authorizations.
  • Work with respective carrier's utilization review department to obtain appropriate authorizations.
  • Assist with appeals processes as and when necessary.
  • Assist with the training of patients and their designated providers on pre-authorization processes and requirements, in person or by phone.
  • Work individually and in a team environment to educate assigned Field Territory Managers and Clinical Specialists.

Requirements

  • Associates Degree in Nursing/Home Health (LVN/LPN) or related field OR an equivalent combination of education and experience.
  • Minimum of 2 years in a utilization (medical approval) environment or similar work experience.
  • General knowledge of private insurance, Worker's Compensation, and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review.
  • Proficient with Microsoft Office (Word & Excel specifically).
  • Ability to accurately meet required time frames/deadlines.
  • Ability to work as a team player and share workloads with other team members.
  • Excellent communication skills; verbal and written.
  • Previous experience in public speaking or presenting to small groups.
  • Attention to detail.
  • Excellent organization skills and ability to multi-task in a fast-paced environment.

Preferred Qualifications

  • Experience in medical device or DME Billing a plus.
  • Knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding).

About Abbott Laboratories

Abbott Laboratories is an Equal Opportunity Employer, committed to employee diversity. We offer a comprehensive benefits package, including medical, dental, and vision coverage, as well as a 401(k) plan and tuition reimbursement. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity.

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