Offer summary

Qualifications:

Associate’s degree in business administration required; bachelor’s degree preferred., Minimum of 3 years of experience with third party health insurance claims processing., Knowledge of medical terminology, coding (CPT, ICD9, HCPC), and healthcare billing applications., Excellent customer service, communication, and organizational skills..

Key responsibilities:

Research and update drug copay programs in the EMR system.

Communicate changes in policies and procedures to Rev Cycle Leadership and provide training on new programs.

Assist patients with billing issues related to copay assistance and maintain accurate records of enrollment and financial assistance.

Coordinate with multiple departments to ensure patients receive necessary medications and process claims for patient assistance programs.

Job description

New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service. Like our owner hospitals, NELC provides patient focused care.

New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you’re energized by this opportunity, but your experience doesn’t support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for!

New England Life Care currently has an opening for a Patient Assistance Program Specialist. This is a full-time, hourly, non-exempt position. The normal working hours will be Monday – Friday from 8:00am until 5:00pm.

Although this is a remote position, we are only hiring in the following states: Massachusetts, New Hampshire, and Maine.

Job Summary: The person in this position helps patients access affordable prescription medications by identifying and enrolling them in manufacturer copay assistance programs that can reduce their costs for medications.

Primary Responsibilities:

Research & add any new drug copay programs to the EMR. Keep up with changes and updates on all programs and always ensure the department manual has the most up to date information.
Communicate to Rev Cycle Leadership changes to understand policies and procedures related to copay assistance and set up training on any new programs
Maintain paperwork as required by all programs and scan supporting documents to patient’s medical records in EMR.
Maintain up to date knowledge on the manufacturer copay portals as necessary to ensure accurate accounting and billing information.
Work with NELC departments to ensure patients receive the needed medications with appropriate documentation and requirements met for free drug programs.
Assist patients with understanding and resolving billing issues related to copay assistance
Keep accurate records of patient enrollment, program participation, and financial assistance provided.
Return or receive patient phone calls within 24 hours during office hours to coordinate applications for patient assistance program medications.
Bill out claims to patient assistance programs timely to ensure prompt payments.
Work with multiple departments to ensure a smooth transition for the patient when a patient is identified in the free drug program.
Process Copay Assistance Credit card payments once claims are approved by drug manufacturer.
Refund and/or appeal unpaid claims to resolve billing issues keeping the AR current.

Additional Responsibilities:

Identify The ability to structure large complex data sets to find usable information
Visualize data insights and communicate your findings to teams across the organization

Educational / Professional Requirements

Associate’s degree in business administration required; bachelor’s degree in business administration preferred.
A minimum of 3 years of experience with third party health insurance claims office or plan administrator involved in processing health provider claims.
A working knowledge of government health insurance plan benefits and rules & regulations for obtaining reimbursement
Experience with healthcare patient accounting/billing/collections computer applications including electronic claims processing preferred.
Working knowledge of Home Infusion Therapy billing & collection preferred.
Practical experience with Medicare, Medicaid, and third-party payer contracts.

Regulatory Requirements:

Knowledge of HIPAA Privacy and Security requirements
Working knowledge of federal / state fraud and abuse laws.

Required Skills:

Demonstrated knowledge of medical terminology; CPT; ICD9; and HCPC coding
Excellent customer service skills.
Excellent communications (verbal and written) skills
Excellent organizational skills
Ability to work independently as well as part of a team
Practical experience with microcomputer systems and applications to include Microsoft Word and Excel
Demonstrate ability to identify, research and solve problems

"It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.”

EOE

Monday – Friday from 8:00am until 5:00pm.

Required profile