Patient Access Appeals Case Manager – VA

🕒 6 dias atrás

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Noctrix Health, Inc.

SiteLinkedInTodas as Vagas

11 - 50 funcionários

Fundada em 2018

⚕️ Seguro de Saúde

🧬 Biotecnologia

☁️ SaaS

Healthcare Insurance • Biotechnology • SaaS

Noctrix Health, Inc. é uma empresa pioneira focada no desenvolvimento de terapêuticas vestíveis de próxima geração, clinicamente validadas, voltadas para o manejo de distúrbios neurológicos crônicos. Com a missão de atender as necessidades não supridas de indivíduos que vivem com essas condições, a Noctrix combina a expertise de experientes especialistas em dispositivos médicos, neurocientistas e engenheiros para oferecer terapias inovadoras que melhoram a experiência do usuário. O produto carro-chefe da empresa, Nidra, recebeu a Designação de Dispositivo Inovador da FDA e é projetado para condições como a Síndrome das Pernas Inquietas, representando um avanço promissor na tecnologia vestível de saúde.

Descrição

• Serve as the primary point of contact for patients, healthcare providers, and insurance companies regarding access and reimbursement for Noctrix therapy • Guide patients through the reimbursement process, including benefit verification, prior authorization, claims processing, and financial assistance programs • Educate patients on insurance coverage, out-of-pocket responsibilities, and available support resources • Collaborate with healthcare providers to obtain required clinical documentation and supporting information for prior authorization and reimbursement requests • Coordinate with insurance companies to ensure timely and accurate review of claims and authorization requests • Stay current on payer policies, coverage criteria, reimbursement guidelines, and industry changes impacting patient access • Maintain accurate and detailed patient records, case notes, and documentation within CRM and reimbursement systems • Identify and resolve access or reimbursement barriers by partnering with internal cross-functional teams • Provide exceptional customer service while addressing patient, provider, and payer inquiries • Support the development of patient and provider educational materials, tools, and resources designed to streamline the access process • Assist with continuous improvement initiatives to optimize patient access workflows and reimbursement outcomes

🎯 Requisitos

• Bachelor's degree in Business, Healthcare Administration, Marketing, or a related field preferred • Minimum of 5 years of experience within the healthcare industry, including pharmaceutical, medical device, or reimbursement-focused roles • Minimum of 2 years of medical device reimbursement experience involving DME products • Experience navigating commercial, Medicare, and government payer reimbursement processes • VA and Medicare reimbursement experience preferred • Strong understanding of benefit verification, prior authorizations, appeals, and reimbursement workflows • Excellent verbal and written communication skills • Strong analytical and problem-solving abilities • Demonstrated ability to collaborate effectively across internal and external stakeholder groups • Strong organizational skills with the ability to manage multiple patient cases simultaneously • Experience with CRM systems and reimbursement platforms preferred

🏖️ Benefícios

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development • Bonuses