Patient Access Appeals Case Manager – VA

🕒 2 days ago

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Noctrix Health, Inc.

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2018

⚕️ Healthcare Insurance

🧬 Biotechnology

☁️ SaaS

Healthcare Insurance • Biotechnology • SaaS

Noctrix Health, Inc. is a pioneering company focused on developing next-generation, clinically validated wearable therapeutics aimed at managing chronic neurological disorders. With a mission to address the unmet needs of individuals living with such conditions, Noctrix combines expertise from seasoned medical device experts, neuroscientists, and engineers to deliver innovative therapies that enhance user experience. The company's flagship product, Nidra, has received FDA Breakthrough Device Designation and is designed for conditions like Restless Legs Syndrome, representing a promising advancement in wearable health technology.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

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