Patient Success Specialist

Position Summary:

The Patient Success Specialist will work with all patient-specific eligibility verifications with payers, claim submissions/ investigations, product grid and
analysis of the current patient status and manage various reporting functions. The candidate must ensure strong organization, including strict adherence guidelines and regulatory requirements. The current role is a key contributor to modifications to internal/external department protocols and SOP for current processes to expand upon additional product lines of payer submissions. Establish priorities, ability to multi-task accordingly. Confer with Management to determine the progress of work and to provide information on changes.

Primary Responsibilities:

• Address the needs of patients with a focus on customer support, coordination of logistics, and problem solving.
• Schedule and coordinate the flow of work within or between departments to expedite project efficiencies and resolution to escalations.
• Address and resolve assigned inquiries with a sense of urgency.  These include but are not limited to patients, sales team, clinic, and executive inquiries and/or escalations.
• Ensures timely closure of escalation cases using email, phone, or salesforce.com
• Adhere to pre-established guidelines and specific instructions and training, to effectively perform the functions of the job.
• Review standard operating procedures for common departmental tasks/duties.
• Other duties as assigned by Management.
• Ensure all data and analysis requests from different parts of the organization are addressed in a timely manner.
• Owning the second level line of escalation to our patient billing call center agents and field teams.
• Responsible for patient outreach effort to resolve escalated issues using all forms of communication (SMS, email, phone) 
• Participates with operational programs, projects and initiatives that help drive the sustaining business forward through patient resolution.
• Keeps key internal leaders and other stakeholders apprised of the escalation status.
• This role works with PHI on a regular basis both in paper and electronic form and have access to various technologies to access PHI (paper and electronic) in order to perform the job.
• Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire.
• Must maintain a current status on Natera training requirements.
• Patient Success Specialists are assigned a designated phone line but are also cross trained to help support additional lines when call volumes fluctuate. Reassignments can vary from short term to permanent changes based on business need. 
• Agents are also assigned a designated shift schedule, but must maintain schedule flexibility between 7 AM and 7 PM to accommodate possible shift changes due to call volume fluctuations and changing business needs. 

Qualifications:

• Bachelor’s degree or equivalent experience
• Experience with medical billing and coding, preferably in a skilled nursing environment
• Excellent customer service skills and phone manner
• Ability to manage stress in a fast-paced environment
• Strong knowledge of Medicare and Medicaid practices
• Minimum 2 years of Call Center experience in an inbound and outbound capacity.
• Minimum 2 years salesforce.com experience