Title:  Senior Patient Affairs Specialist

Summary

Provides information to patients and maintains good patient rapport. Obtains insurance pre-certifications and verifications and ensure reimbursement from patients or other responsible parties.

The ideal candidate will have infusion and specialty verification and authorization submission experience as well as infusion and general specialty services benefits and authorization experience.

Job Duties

• Financially clears patients for upcoming services.
• Responds to and assists physician with patient questions.
• Obtains benefits, creates estimates for patient out of pocket, and submits authorizations for services.
• Follows up on submitted authorizations, notates authorization in appropriate area in Epic for all services. 
• Contacts patient to collect out of pocket expenses. 
• Contacts departments regarding missing clinical information if required by insurance company. 
• Contacts PCP offices to obtain referrals. 
• Understands high level specialty services authorizations.
• Updates referral statuses and collection efforts in Epic. 
• Answers Insurance Verification Helpline and solves insurance issues for patients, physicians, and departments.
• Responds to specific account inquiries by management.
• Creates estimate letters that are electronically forwarded to patients to inform them of their financial responsibility.
• Provides and explains educational material to patients. 
• Investigates insurance coverage and demographics.
• Researches claims denied for no authorization and performs retro authorizations
• Answers phones and provides information to patients or takes detailed messages and routes them to the appropriate party.
• Answers help line calls and assists patients with questions.
• Answers help line email and assists patients with questions.

Minimum Qualifications

• High school diploma or GED.
• Three years of relevant experience.

Preferred Qualifications

• Infusion and specialty verification and authorization submission experience.
• Infusion and general specialty services benefits and authorization experience.