Patient Therapy Access Specialist
Plano, USA
Job description
Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries.
JOB DESCRIPTION:
Working at Abbott
At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You’ll also have access to:
· Career development with an international company where you can grow the career you dream of.
· Free medical coverage for employees* via the Health Investment Plan (HIP) PPO
· An excellent retirement savings plan with high employer contribution
· Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
· A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune.
· A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists.
The Opportunity
Our Neuromodulation business is an area of expertise for Abbott. This business includes implantable devices compatible with mobile technology to help people who suffer from chronic pain and movement disorders. Our Solutions include Proclaim (TM) XR SCS System, the #1 Spinal cord stimulator on the market, Proclaim (TM) DRG Neurostimulator, the only FDA approved DRG therapy and a market leader in radiofrequency ablation therapy, Abbott RFA. These non-opioid therapies allow us to provide interventional pain therapy to patients throughout the pain continuum. Our deep brain stimulation technology for progressive diseases help people manage their Parkinson’s disease and essential tremor symptoms, steering away from side effects.
Our location in Plano, TX currently has an opportunity for a Patient Therapy Access Specialist (PTA). As a PTA Specialist you are responsible for facilitating and assisting Abbott patients with the pre-certification, pre-determination and authorization process necessary as a prerequisite to perform various procedures or forms of therapy based on physician recommendation.
WHAT YOU’LL WORK ON:
· Assist with multiple levels of appeal in the event of initial coverage denial.
· Forward authorized confirmation for procedure to designated patient provider. In addition, this position will provide in-servicing to new patient providers surrounding the pre-authorization process.
· Responsible for managing multiple cases simultaneously within specific time frames
· Follow all policies and procedures related to performing the job role adhering to all data use, storage and privacy policies as outlined by Abbott
· Verify benefits, complete authorization requests promptly
· Timely follow up for requested authorizations
· For each procedure, audit required clinical documents for completeness and accuracy
· Obtain authorization for the facility, equipment and physician to perform various procedures from the insurance carrier
· Work with key provider contacts to obtain required clinical information for authorizations
· Work with respective carrier’s utilization review department to obtain appropriate authorizations
· Work within established guidelines when necessary to process appeal for denied requests
· Train patients and their designated providers on pre-authorization processes and requirements, in person or by phone
· Work individually and in a team environment to educate assigned Field Territory Managers and Clinical Specialists
EDUCATION AND EXPERIENCE YOU’LL BRING
Required Qualifications
· Minimum of 2 plus years experience in a utilization (medical approval) environment or similar work experience
Preferred Qualifications
· Knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review.
· Experience in medical device or DME Billing a plus
· Proficient with Microsoft Office (Word & Excel specifically)
· Medical billing software experience a plus
· Knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding)
· Ability to accurately meet required time frames/deadlines
· Ability to work as a team player and share workloads with other team members
· Excellent verbal and written communication skills
· Ability to train/present concepts to others
*Participants who complete a short wellness assessment qualify for FREE coverage in our HIP PPO medical plan. Free coverage applies in the next calendar year.
Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: www.abbottbenefits.com
Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity. Connect with us at www.abbott.com , on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews.
The base pay for this position is
$19.60 – $39.20/hour
In specific locations, the pay range may vary from the range posted.
JOB FAMILY:
Clinical Affairs / Statistics
DIVISION:
MD Medical Devices
LOCATION:
United States > Texas > Plano : 6600 Pinecrest
ADDITIONAL LOCATIONS:
WORK SHIFT:
Standard
TRAVEL:
No
MEDICAL SURVEILLANCE:
Not Applicable
SIGNIFICANT WORK ACTIVITIES:
Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day), Keyboard use (greater or equal to 50% of the workday)
Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.
EEO is the Law link - English: http://webstorage.abbott.com/common/External/EEO_English.pdf
EEO is the Law link - Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf