Patient Access Specialist

Globus Medical•Collegeville, PA

About The Position

The Patient Access Specialist provides payer coverage support to customers throughout the patient access process, from reviewing initial documentation through prior authorization, appeals support, claims review, and hotline assistance. The role provides expertise on payer coverage and related patient access activities, supports customers with documentation and education about coverage requirements, and follows up on assigned work while meeting service-quality metrics. The Specialist works with the Supervisor and other team members to maintain achievable turnaround times, stay informed about payer policies and patient requirements for HF10 therapy, and understand how health care reform affects access. The role requires adherence to quality processes, patient confidentiality and HIPAA requirements, company policies, and applicable laws and regulations. The Specialist is also expected to represent the company professionally and ethically in interactions with employees, customers, suppliers, and other third parties.

Requirements

Bachelor’s degree in health economics, life sciences, public health, public policy, finance, business, or marketing, or equivalent work experience.
1–2 years of customer service, patient access, or prior authorization experience.
Experience complying with regulatory requirements and company policy when dealing with customers and patient confidentiality.
Applicable customer service and/or reimbursement support experience related to appeals and prior authorizations from a payer, provider, medical device, or pharmaceutical industry.
Ability to work with various teams to accomplish organizational goals.
Excellent verbal and written communication skills.
Analytical focus and strong attention to detail.
Ability to follow work processes.
Courteous, professional, and balanced approach with a tenacious drive to assist customers and the HFX Access team in achieving goals.
Ability to multitask and prioritize workflows.
Excellent organizational and project management skills.
Strong interpersonal skills to influence or negotiate complex decisions, demonstrate leadership in communicating the HFX Access team’s mission, objectives, and results, and build cross-functional relationships.
Working knowledge of medical terminology.
Knowledge of HCPCS coding.
Knowledge of ICD-10 coding.

Responsibilities

Adhere to HFX Access service quality standards through quality assurance, additional training, and process improvement.
Work with the Supervisor to focus on realistic and achievable turnaround times for department functions.
Review physician-provided documentation for completeness and identify information needed to complete a case.
Meet or exceed metrics in the designated region to ensure quality service to all customer types.
Provide documentation and follow-up to support prior authorization and appeals processes, and educate customers about payer coverage requirements.
Stay current with team members on payer coverage policies, patient requirements for HF10 therapy, and the impact of health care reform on patient access to HF10 therapy.
Comply with company policies, particularly patient confidentiality and HIPAA requirements, in HFX Access practices.
Perform other duties as required.
Adhere to the company Code of Conduct, the AdvaMed Code, the MedTech Code, and other company policies.
Complete introductory and annual compliance training and maintain knowledge of applicable governmental laws, rules, and regulations.
Represent the company professionally and uphold ethical business practices and socially responsible conduct in interactions with employees, customers, suppliers, and other third parties.