Patient Access Specialist

The Patient Access Specialist is responsible for performing detailed insurance benefit verifications while maintaining effective communication and attention to detail. This role is a part of the Customer Operations Department.

The Patient Access Specialist is based either on-site in a Kerecis office or, in areas where Kerecis does not have a location, in a home office. The role reports to the Patient Access Specialist Manager.

Essential Functions

• Protect confidential patient health information (PHI) at all stages of the verification of benefits process
• Verify medical benefits for patients seeking treatment with Kerecis products including detailed review of patient responsibility for Kerecis treatment
• Verify authorization requirements and initiate prior authorizations while considering payer coverage criteria information
• Prepare and send insurance benefit verification results to healthcare providers on deadline
• Report and resolve any payer delays/challenges and/or escalated complaints
• Collaborate with Market Access and Reimbursement teams
• Maintain an elevated quality of work to facilitate improved access of treatment for patients in need
• Other tasks and responsibilities as assigned

Competencies & Attributes

• Strong verbal and written communication skills
• Passionate about providing patients with access to care
• Ability to work on a team aiming for collective success
• Ability to work independently and problem solve
• Knowledge of medical terminology
• Working understanding of medical insurance

education & experience

• Highschool diploma or equivalent required, bachelor’s degree preferred
• Min 1 year working with prior authorization/insurance verifications preferred