VOB Specialist - Patient

Job Description

Job Description

VOB Specialist - Patient

Location: Plano, TX

Onsite Flexibility: Onsite

• Position Type: Contract
• Contract Duration: 6 months (with possible extension)
• Pay Rate: $20.87 $21.00 / 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.

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 patients with the pre-certification, pre-determination, and authorization process required before performing various procedures or forms of therapy based on physician recommendation.

• 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-service training to new patient providers regarding 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 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 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.

• Experience with insurance carriers.
• Experience with verification of benefits and portals.
• Proficient with computer, Adobe, Salesforce, and Microsoft Office.
• Has worked in a physician's office or has a physician's office background.
• Strong communication skills.
• Strong organizational skills.
• Understanding of co-insurance and benefit understanding.

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

• High school diploma required.
• Associate degree a plus.

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

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

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

This client is a leading healthcare innovator with more than 140 years of history improving lives worldwide, operating across medical devices, diagnostics, nutritional products, and established pharmaceuticals in more than 160 countries. The organization's portfolio spans cardiovascular care, diabetes management, diagnostic testing, nutrition, and neuromodulation, with innovations that reach millions of patients every day. With a workforce that includes biomedical engineers, clinical scientists, regulatory affairs specialists, and commercial operations professionals, the organization is a certified Great Place to Work, with 80 percent of employees reporting it as a great place to work, well above the national average.

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: 26-13775

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