Patient Access Intake Specialist II

Patient Access Intake Specialist II

Work mode: Remote in Country

Onsite Location(s): United States

Additional Location(s): N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we'll help you in advancing your skills and career. Here, you'll be supported in progressing whatever your ambitions.

Shift Hours: 7:00 AM - 4:00 PM or 8:00 AM - 5:00 PM

About the Role

The Patient Access Intake Specialist is responsible for the initial review of the patient case through submission to the insurance plan for prior authorization. Works closely with Intracept team members and external customers (physicians and patients) to ensure clean and timely submissions. At Boston Scientific, we value collaboration and synergy. Relocation assistance is not available for this position at this time. Boston Scientific will not offer sponsorship or take over sponsorship of an employment VISA for this position at this time.

Your responsibilities will include:

• Confirms case information is complete and supports medical necessity.
• Obtains additional information from the physician or patient as needed.
• Follows up timely on assigned tasks to ensure optimal case progression.
• Communicates internally and externally to resolve case related issues.
• Submits prior authorization requests by phone or fax to the payer.
• Manages incoming faxes and correspondence, distributing to Case Managers in a timely and accurate manner.
• Prioritizes tasks according to urgency.
• Applies pressure on health plans that refuse to review based on negative or absent coverage policy for the procedure.
• Drafts all case related communication to physicians, patients and payers in a clear and concise manner.
• Documents all case activity and correspondence for cases in a timely manner to provide chronological details of case progress.
• Acts as a resource for fellow team members and new employees.

Skills:

• Demonstrated ability to navigate the prior authorization process with commercial and government payers.
• Strong ability to read clinical records and extract pertinent information for submission.
• Demonstrated knowledge of payer medical policies and criteria requirements.
• Ability to follow process and protocol and communicate when/if changes are needed.
• Ability to work within multiple software systems.
• Ability to adapt as the needs of the business change or evolve.
• Excellent verbal and written communication skills.
• Excellent interpersonal skills.

Required Qualifications:

• 1-2 Years with High School Diploma and/or equivalent experience, training, or apprenticeships
• Minimum 2 years commercial insurance prior authorization experience.
• Secure home office space with ability to protect HIPAA sensitive materials.
• Must be willing to travel as needed (<5%).

Preferred Qualifications:

• Pain management or spine specialty preferred.

Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs.

Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identify, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.