Patient Access Consultant

Location: Remote, United States

Shift Hours: 8:30 am - 5:30 pm EST

Primary Duties and Responsibilities:

• Master of all standard and advanced services and willing to perform them as needed for the good of our patients. Including but not limited to:
  • Billing and coding support
  • Claims assistance, tracking and submission
  • Prior authorization assistance and tracking
  • Coordination of benefits
  • Benefit verification result call
  • Welcome calls g. Advanced alternate coverage research
  • Appeals/Denials
  • Inbound Phone Queue/General Program Inquires
  • Determination for support programs (Copay, PAP, Medicaid, etc.)
  • Pharmacy triage and coordination
  • Order processing for wholesale orders
  • Other follow-up activities (missing info, prior authorization, etc.)
  • Intakes and reports adverse events as directed.
  • Non-Clinical adherence services
• Engages with manufacturer representatives around items like payer profiles, reimbursement trends, issues with specific offices etc.
• Responsible for coordination of services with field reimbursement teams and sales representatives.
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
• Independently analyzes, reports, resolves, and communicates any reimbursement trends/delays (e.g. billing denials, claim denials, pricing errors, payments, etc.).
• Processes any necessary correspondence.
• Coordinates with internal and external service providers to ensure services are performed in accordance with program policy and within expected service level agreements (SLA).
• Provides training and support to internal associates.
• Fields questions from program representatives and specialist.
• Handles initial customer escalations.
• Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate.
• Independently and effectively resolves complex accounts with minimal supervision.
• Maintains confidentiality in regards to all patient sensitive information.
• Works on complex issues where analysis of situations or data requires in-depth evaluation of variable factors. Exercises judgment in selecting methods, techniques and evaluation criteria for obtaining results. Networks with key contacts outside own area of expertise.
• Acts independently to determine methods and procedures on new or special assignments.
• Performs related duties and special projects as assigned.

Experience and Educational Requirements:

High school diploma or GED required. Requires broad training in fields such as business administration, accounting, computer sciences, medical billing and coding, customer service or similar vocations generally obtained through completion of a two-year associate’s degree program, technical vocational training, or equivalent combination of experience and education. Five years (5) + years directly related and progressively responsible experience required. A two-year degree can be used in lieu of 2 years of the experience requirement, a four-year degree in lieu of 4 years of experience. Four-year degree preferred.

Minimum Skills, Knowledge, and Ability Requirements:

• Ability to communicate effectively both orally and in writing.
• Ability to build productive internal/external working relationships.
• Advanced interpersonal skills.
• Strong mathematical skills.
• Basic analytical skills.
• Advanced organizational skills and attention to detail.
• Extensive knowledge of pharmacy operations and medical claims.
• Excellent use of medical industry vernacular.
• General knowledge of health care billing required. Advanced knowledge preferred.
• Advanced use Microsoft Excel, Outlook and Word.
• Developing professional expertise; applies company policies and procedures to resolve a variety of issues

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/cencora

*This Salary Range reflects a National Average for this job. The actual range may vary based on your locale. Ranges in Colorado/California/Washington/New York/Hawaii/Vermont/Minnesota/Massachusetts/Illinois State-specific locations may be up to 10% lower than the minimum salary range, and 12% higher than the maximum salary range.

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned

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