Patient Access Lead, Full Time- Remote

As the Patient Access Lead, you will support the Patient Services department and facilitate the infusion admission process. You will collaborate with and support the Patient Access Managers by ensuring thorough and accurate processing of referrals and updated orders, including insurance eligibility and benefits verifications, prior approvals, and data entry. Additionally, you will support continuity of care for existing patients by ensuring eligibility, current financial documents, and prior approval renewals are reviewed and maintained prior to patient appointments.

Responsibilities

• Serve as a Subject Matter Expert (SME) in all aspects of the Patient Access functions, responsibilities, and processes & procedures.
• Be proficient in all applicable systems, programs, resources, and tools.
• Assist with all Patient Access functions as needed per business demands.
• Maintain working knowledge of insurance contracts and exclusions.
• Stay knowledgeable of applicable CPT, HCPCS, and ICD-10 codes.
• Maintain familiarity with drug copay assistance program requirements to determine patient eligibility.
• Uphold and promote adherence to HIPAA guidelines.
• Generate and manipulate Excel spreadsheets to sort, condense, and prioritize data.
• Demonstrate exceptional written and verbal communication skills when interacting with insurances, referring office staff, patients, and internal & clinical staff.
• Communicate and maintain contact with the Patient Navigator, Medical Records Review, and Patient Resources teams regarding patient accounts, referral documentation, insurance, and coordination of benefits concerns.
• Utilize appropriate templates, naming conventions, formats, and email distribution lists for system notations and email & task communication.
• Conduct training for new and existing employees, including onboarding and refresher training sessions.
• Act as a key point of contact for the Patient Access team.
• Assist Patient Access Managers in driving team goals, guidelines, and expectations.
• Monitor team workload and productivity.
• Complete regular Quality Assurance (QA) audits.
• Respond to escalations and concerns.
• Make recommendations for improvements to established processes and procedures.
• Run and build daily, weekly, monthly, and ad hoc reports for review and assignment.
• Facilitate schedule review reports, authorization tracking, and other routine reports.
• Assist and support leadership in communication regarding process changes, function and responsibility coverage, and guidelines updates.
• Assist with managing the workload and coordinates coverage to ensure referrals and orders are handled in a timely manner.
• Identify and escalate team performance issues and communicate concerns to the manager.
• Collaborate with the manager in educating team members toward improvement and provide peer feedback as directed.
• Act as a key participant and co-presenter on weekly calls as outlined by the manager.
• Assist in various projects such as claim projects, patient data audits, and acquisition assistance.
• Maintain spreadsheets for data management.
• Facilitate month-end processes in any capacity.
• Maintain patient records and confidentiality via the electronic Medical Record System.
• Develop effective communication mechanisms for the Home Office to promote a positive image with clinics, patients, visitors, co-workers, physicians, office personnel, and external agencies.
• Demonstrate the Vivo culture.
• Attend necessary meetings related to department activities.
• Perform other duties as assigned.

Requirements

• 3+ years of experience working in high-volume insurance verification, benefits, and eligibility/authorizations.
• 2 years of medical billing and authorizations or managing physician referrals.
• 1 year of experience working in a customer service or patient-facing role.
• High school graduate or equivalent; associate’s or bachelor’s degree preferred.
• Proficient (intermediate level) with all Microsoft Office Products programs.
• Advanced knowledge of insurance, accounting, medical billing, HIPAA, Medicare/Medicaid, medical abbreviations, and terminology.
• Outstanding communication and interpersonal skills.
• Experience supporting multiple managers/supervisors.
• Prior experience working with sensitive information and maintaining confidentiality.
• Minimal travel up to 10%.

Qualifications

• Minimum 3+ years of related prior work experience required, preferably in admission, scheduling, and medical insurance within the healthcare industry.
• Proven competencies can take precedence over prior work experience.
• Must possess excellent communication and interpersonal skills, be able to communicate professionally and effectively with staff, patients, vendors, and physicians, and be fluent in written and spoken English.

Benefits

• Medical, Dental, Vision
• HSA with Employer Contribution
• Touchcare - Insurance Concierge Service
• 401K with Match up to 4%
• PTO: Accrual 3+ weeks
• PTO Buy-back, PTO Rollover, and PTO Donation Program
• Wellness Reimbursement Program - $360 Annually
• Employee Referral Bonus - Uncapped Bonus Potential
• Tuition Assistance Program & Professional Association Reimbursement
• Employee Assistance Program (Employer-provided)
• Short & long-term disability (Employer-provided)
• Life Insurance (Employer-provided)
• Company-wide Employee Ownership Program

Pay

Pay Range: $28.00 - $30.00/Hour

Bonus Plan Target: 5% Annually (Based on performance)

Schedule

Full-time

Monday-Friday | Flexible hours 7:00am - 7:00pm EST

Non-Exempt

Work Environment & Physical Demands

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• Regular exposure to work near moving mechanical parts (medical equipment and machinery).
• Possible exposure to fumes or airborne particles and toxic or caustic chemicals.
• Moderate noise level in the work environment.
• Specific vision abilities required include close vision, color differentiation, distance vision, peripheral vision, depth perception, and ability to adjust focus.
• Required to stand, walk, talk, hear, and smell.
• Requires excellent visual acuity and manual dexterity.
• Frequently required to use hands to finger, handle, or feel and reach with hands and arms.
• Frequently required to sit; stoop, kneel, bend, crouch, or crawl.
• May be required to use safety equipment, PPE (personal protective equipment) including face shield or goggles, non-slip shoes, gloves, mask, and other protective garments and equipment.

This role will work remotely from a home office with a secure network. Only candidates residing in the following states at the time of employment will be considered: Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin, Wyoming, Washington D.C.

Travel with Vivo equipment is not permitted without prior approval.