Patient Access Specialist

🔥 3 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CareMetx, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

CareMetx, LLC is a company that specializes in transforming patient access to specialty therapeutics by reducing the time to therapy. They offer a digital Hub service that addresses emotional, financial, and clinical barriers for patients, aiming to improve treatment timelines and ongoing therapy use. CareMetx provides high-touch support and utilizes advanced technology to offer solutions for access, affordability, and adherence, benefiting both patients and healthcare providers. They partner with specialty pharmaceutical brands, healthcare providers, and hospital systems to enhance patient outcomes.

📋 Description

• Provide advanced services to patients, providers, and caregivers for manufacturer-sponsored programs • Provide billing and coding support • Assist with, track, and submit claims • Assist with and track prior authorizations • Coordinate benefits • Conduct benefit verification result and welcome calls • Research advanced alternate coverage • Handle appeals and denials • Intake and report adverse events as directed • Provide exceptional customer service and resolve or escalate requests and complaints • Establish regional expertise regarding payer trends and report reimbursement trends and delays to management • Process necessary correspondence • Coordinate with internal and external service providers according to program policies and service level agreements • Maintain confidentiality of patient-sensitive information • Analyze data and resolve moderately scoped problems using defined procedures • Work independently from phone or system queues according to standard operating procedures • Perform related services such as benefit verifications and Patient Assistance Program determinations

🎯 Requirements

• High school diploma or GED required • Minimum of four (4) years of directly related and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration or similar vocations • Equivalent combinations of education and experience will be considered • Advanced customer service experience • Ability to communicate effectively both orally and in writing • Ability to build productive internal/external working relationships • Advanced interpersonal skills • Basic analytical skills • Advanced organizational skills and attention to detail • Proficiency with Microsoft Excel, Outlook and Word • General knowledge of the healthcare industry preferred • Must be flexible on schedule and hours • Ability to sit regularly and occasionally lift or move up to 10 pounds

🏖️ Benefits

• Reasonable accommodations for individuals with disabilities • Equal employment opportunity and non-discrimination commitment • Human review of AI-supported recruiting and employment decisions