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Patient Access Representative
Remote Minneapolis, MN 55448 US
Job Description
The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative will ensure patient insurance coverage and benefits, identify requirements for prior approval and submit for authorization. Assists with appealing prior authorization denials, retro authorization or other special cases
Responsibilities Include, But Are Not Limited To
- Validates insurance patient’s coverage, communicate any issues with benefits or coverage to the appropriate managers
- Checks the requirements for prior authorization and initiates as required
- Coordinates required paperwork, clinical notes and forms for submission to support request and initiates as required
- Follows up frequently to ensure visibility on authorization status throughout the approval process
- Basic knowledge payer payment process with detailed knowledge on the payer prior authorization process
- Basic ICD9/10 and CPT code familiarity, expert knowledge on subset of company therapy codes
- Superior customer service skills with outstanding communication skills to use with various stakeholders; physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders,
- Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed
- Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail
Equal Opportunity Employer: We are proud to be an equal opportunity employer. We welcome and encourage applications from all qualified candidates regardless of race, sex, gender identity or expression, disability, age, religion or belief, sexual orientation, or any other characteristic protected by applicable laws and regulations. It is our policy not to discriminate against any applicant or employee, and we are committed to fostering a diverse, inclusive, and respectful work environment across all locations in which we operate. We believe that diversity, equity, and inclusion are fundamental to our mission and enhance our ability to serve clients globally. If you have a disability or require any reasonable accommodations during the application or interview process, please inform your recruiter or contact us directly so that we can explore the appropriate arrangements.
Fraud Alert: Candidate safety is a top priority at Planet Pharma. The industry has seen an increase in people falsely representing themselves as recruiters to gather personal information from job seekers. For your safety, do not provide sensitive data to anyone you have not spoken with thoroughly, never provide banking information during the application process and always double check the email address of the Recruiter to ensure it’s from an official Planet Pharma domain (@planet-pharma.com, @planet-pharma.co.uk, and @ppgadvisorypartners.com) and not a domain with an alternative extension like .net, .org or .jobs.
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