VOB Specialist - Patient Therapy

Patient Therapy Access Specialist

Location: Plano, TX

Onsite Flexibility: Onsite

Contract Details

• Position Type: Contract
• Contract Duration: 6 months (with potential for extension)
• Pay Rate: $20.87 / Hour (USD)
• Shift / Schedule: Monday - Friday, 8:00 AM - 5:00 PM
• Work Authorization: Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Job Summary

Our Plano, TX location currently has an opportunity for a Patient Therapy Access Specialist (PTA) . As a PTA Specialist, you are responsible for facilitating and assisting 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.

Key Responsibilities

• Assist with multiple levels of appeal in the event of initial coverage denial.
• Forward authorized confirmation for the procedure to the designated patient provider. In addition, this position will provide in-service training 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.
• 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 the required clinical information for authorizations.
• Work with the respective carrier's utilization review department to obtain appropriate authorizations.
• Work within established guidelines when necessary to process appeals 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.

Required Skills

• Experience with insurance carriers.
• Experience with verification of benefits and portals.
• Proficient with Computer, Adobe, Salesforce, and Microsoft Office.

Preferred Skills

• Knowledge of private insurance, Worker's Compensation, and Medicare guidelines about Prospective and Retrospective Utilization Review.
• Experience in medical device or DME Billing is a plus.
• Proficient with Microsoft Office (Word & Excel specifically).
• Medical billing software experience is 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.

Education Requirements

• Associate degree in Nursing/Home Health (LVN/LPN) or related field required.

Required Experience

• Minimum of 2 years of experience in a utilization (medical approval) environment or similar work experience.

Benefits

• Medical, Vision, and Dental Insurance Plans
• 401k Retirement Fund

Important Notes

• Interview format: WebEx or panel WebEx only (1st Round Video / 2nd Round Onsite).
• Selected candidate will start ASAP after screenings have cleared.

About the Client

Healthcare Innovator We're a leading healthcare company dedicated to improving lives worldwide. Our diverse portfolio includes medical devices, diagnostics, nutrition products, and branded generics. We're committed to developing groundbreaking technologies that address critical healthcare challenges and empower people to live healthier lives.Global Join our team and: Work on cutting-edge projects Contribute to global healthcare advancements Experience diverse cultures and geographies Discover a rewarding career with a company that cares.

About GTT

GTT is a minority-owned staffing firm and a subsidiary of Chenega Corporation, a Native American-owned company in Alaska. We highly value diverse and inclusive workplaces and support Fortune 500 organizations across banking, financial services, technology, life sciences, biotech, utilities, and retail sectors throughout the U.S. and Canada.

Job Number: 26-06218

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