Access Manager

Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company providing complex pharmaceutical products and clinical services to patients outside of the hospital.

About the role

The Access Manager monitors all activities and information related to the processing of new referrals and ongoing coordination of patient customer service. This position completes all personnel-related tasks for Intake employees and works closely with branch personnel, referral sources, and the Revenue Cycle Management department.

Responsibilities

• Leads and manages one of the regional teams responsible for benefit investigation, prior authorization, and intake coordination
• Ensures that all intake forms are complete, clear, and within Amerita’s scope of service
• Understands which insurance companies Amerita has active contracts with
• Ensures intake personnel properly perform all functions related to verifying insurance, obtaining authorizations and re-authorizations, registering patients, communicating with other departments regarding referrals, participating in patient care coordination, and communicating with patients regarding coverage and financial obligations
• Ensures processes are followed to complete insurance verification and authorization prior to giving the referral to the branch
• Keeps staff current with payer requirements and Amerita policy and procedures related to the intake process, CPR+ functions, and managing unbilled revenue
• Understands and adheres to all applicable company policies and state and federal regulations; ensures Intake staff adherence
• Identifies inefficient processes and monitors workload of staff, making recommendations
• Serves as a subject matter expert in local and regional payor requirements, ensuring team alignment with policy changes and payer nuances
• Acts as an escalation point for complex or high-impact patients requiring advanced payer knowledge or cross-functional coordination
• Ensures applicable ready-to-bill holds are resolved timely and performs root cause analysis on holds when necessary
• Participates in and coordinates training for all new intake staff

Supervisory Responsibility: Yes

Requirements

• High School Diploma/GED or equivalent required; Associate’s degree or some college preferred
• A minimum of 3 years experience collecting referral information in the healthcare market (to include 2 years of supervisory experience)
• Experience working with all payer types to include Medicare, Medicaid, and commercial insurance companies
• Home infusion experience a plus
• Knowledge of insurance verification and pre-certification procedures
• Solid Microsoft Office Suite skills
• Strong verbal and written communication skills
• Ability to independently obtain and interpret information
• Knowledge of CPR+ software a plus
• Working knowledge of medical terminology
• 0-25% travel required

Physical Requirements

To perform this role will require frequently sitting, standing, walking, and typing on a keyboard with fingers, and occasionally bending, reaching, climbing (stairs/ladders). The physical requirements include the ability to push/pull 1-10 lbs and lift/carry 21-30 lbs.

Schedule

Monday - Friday, 8:30 am - 5:00 pm MST

Pay

Salary Range: USD $71,900.00 - $89,900.00 per year

Benefits

• Competitive pay
• Health, Dental, Vision & Life Insurance
• Company-Paid Short & Long-Term Disability
• Flexible Schedules & Paid Time Off
• Tuition Reimbursement
• Employee Discount Program & DailyPay
• 401k
• Pet Insurance