Patient Access Liaison

BioMatrix Specialty Pharm•Overland Park, KS

1d•Onsite

About The Position

The Patient Access Liaison is responsible for ensuring the intake/prior authorization processes and workflows are performed optimally and effectively. Work with manager to meet the needs of the department to secure contracts, authorizations and maximize reimbursement coverage.

Requirements

High School Diploma or GED required
Minimum of two (2) years of care coordination or patient services experience, to include medical insurance experience, required
Basic computer and internet skills (e.g. Microsoft Office)
Ability to obtain reimbursement and prior authorizations for patients, family members, caregivers, nurses, physicians, and health plan representatives and/or administrators.
Commitment to excellent customer service and professionalism to resolve complex payer coverage issues
Ability to maintain competence for current position.
Ability to maintain accurate records and prepare reports and correspondence related to the work.
Ability to perform work within specified time frames and adapt positively to frequent interruptions and changes in workload and/or work schedule.
Strong customer service skills, focus and dedication.
Excellent interpersonal and organizational skills.
Ability to set priorities and solve problems.
Excellent verbal, written, and communication skills.
Ability to respond quickly to emergency requests.
Self-motivated, self-reliant and team oriented.
Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings.
Written Communication - Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information.
Become and remain proficient in all programs necessary for execution of the position.

Nice To Haves

Certified Pharmacy Technician/License preferred
Prior home infusion experience preferred
Prior patient financial assistance experience preferred
Prior CareTend experience preferred

Responsibilities

Maintains day-to-day patient authorization and reimbursement activities, workload and overall workflow
Maintains strict confidentiality of patient, visitor, and employee information. Complies with HIPAA Privacy Rule standards.
Receives patient referrals and works on the patient’s behalf to identify and assess reimbursement coverage options for those with insurance and to coordinate and/or investigate financial options for those without insurance.
Obtains and monitors prior authorization process to ensure optimal and effective workflow.
Reports denials or non-eligible patients to the contracts department to identify and secure contractual opportunities.
Works with physician offices and the pharmacy department to facilitate the process of obtaining prior authorization from third party payers in order to maximize patients’ access to treatment.
Communicates effectively with sales team and Regional Care Coordinators.
Monitors and verifies benefits, records all insurance re-authorizations required by payers to help ensure compliance and continuity of treatment monthly.
Contributes to effective operation of the pharmacy department.
Collaborates with the billing team to maintain database for recording, managing, and monitoring patient insurance activities.
Screens incoming orders, notifies pharmacy of insurance eligibility issues, and STAT orders to make same-day deliveries when requested.
Participation in QMC Quarterly Meetings, as needed.
Participates in orientation, education, training programs, CE’s, literature reviews and other materials, as assigned.
Completes all competence/skills billing assessments as required.
Provides courteous, cooperative and timely service to patients, visitors, and staff.
Participates in quality assurance activities and audits, as directed.