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Medical Billing and Patient Representative

Company: Careerbuilder-US
Location: Overland Park
Posted on: September 12, 2023

Job Description:

Medical Billing and Patient Representative Title: Medical Billing and Patient Representative Industry: Specialty Pharmacy Care Location: Overland Park, KS AND Orlando, FL Shift: M-F, 8a-5p, 9a-6p Type: Temp to Permanent Hire Job Scope: The purpose of this position is to help patients get access to the medications and therapies that they need. This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Responsibilities:

  • Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
  • Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
  • Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
  • Identify any coverage restrictions and details on how to expedite patient access
  • Document and initiate prior authorization process and claims appeals
  • Report any reimbursement trends or delays in coverage to management


    • HS Diploma or GED, required
    • 2-5 years of Benefits Investigation knowledge, highly preferred
    • Healthcare experience, preferred
    • Call center experience
    • Prior authorization experience required
    • Need to be adaptable
    • Quick learning
    • Tech savvy
    • Able to work on multiple screens & in multiple programs
    • Great on the phone/empathetic
    • Salesforce system experience, preferred

    • Shifts: 8am-5pm, 9am-6pm, 10am-7pm, 11am-8pm. Training 9:30-5:30 EST (1-hour paid lunch break - this is an 8-hour day, you won't clock out during meal break)

    • Type: Contract-to-hire. If attendance and performance are in line, you can work remote, after 90 days.

      SRG offers flexible staffing solutions with a national presence. We provide contract, contract-to-hire, direct hire and executive search services. SRG utilizes an innovative approach to identify and qualify talent that is unique to the Staffing industry, featuring a cutting-edge platform that allows us to rapidly and precisely match professionals to client requirements. We have a proprietary database of over one million candidates and maintain continuous contact with our qualified talent.

Keywords: Careerbuilder-US, Overland Park , Medical Billing and Patient Representative, Accounting, Auditing , Overland Park, Kansas

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