Patient Resource Specialist

This is a fully remote position, open to applicants in Arizona, +26 more states.

📋 Description

• Educate and inform patients about their insurance benefits and financial obligations.

• Assess, educate, and enroll patients in medication administration assistance programs and financial support initiatives.

• Manage a designated caseload of patients within a specific territory.

• Establish relationships with patients, respond to inquiries, and advocate for their insurance and financial management needs.

• Identify the most suitable financial resources for patients while considering company revenue.

• Document interactions with patients and insurance providers in the EMR system.

• Communicate both written and verbal information to patients, families, supervisors, insurance representatives, and Clinical Operations personnel.

• Collaborate with the ROPs department regarding insurance eligibility and benefits.

• Discuss patient accounts, COB issues, EOBs, APPs, authorizations/referrals, and patient responsibilities with ROPs and management.

• Address patient concerns with ROPs and COPs, provide solutions, and follow up for further assistance from leadership.

• Investigate issues related to insurance coverage loss and determine necessary actions, such as filing appeals or contacting the Department of Labor or Department of Insurance.

• Review EOBs and account notes to evaluate and advise on patient responsibilities.

• Recommend insurance options, including COBRA, EGHP, Medicare, and other plans.

• Assist patients with outstanding balances and resolve financial issues before they escalate to collections.

• Report directly to the Patient Resource Manager.

⛳️ Requirements

• High school diploma or equivalent is required.

• At least 2 years of experience working with insurance and benefits in a similar capacity.

• A minimum of 2 years of relevant work experience is required, ideally within an infusion company.

• Familiarity with medical health insurance, medical billing, HIPAA regulations, Medicare, and relevant medical terminology.

• One year of experience in a customer service role is required, preferably with direct patient interaction.

• Exceptional communication and interpersonal skills.

• Professional and effective communication with colleagues, patients, vendors, and healthcare providers.

• Proficiency in both written and spoken English.

• Skilled in Microsoft Office applications, including Word, Excel, PowerPoint, Teams, and Outlook.

• Must reside in one of the specified states at the time of employment.

• Ability to satisfactorily perform each essential duty.

• Capability to sit, stand, walk, talk, and hear; occasionally lift and/or move up to 25 pounds.

• Excellent visual and manual dexterity.

🏝️ Benefits

• Bonus Plan Target: 5% Annually (Based on performance).

• Company-wide Employee Ownership Program.

• Medical, Dental, Vision coverage.

• Health Savings Account (HSA) with Employer Contribution.

• Touchcare - Insurance Concierge Service.

• 401K with a match of up to 4%.

• Paid Time Off (PTO): Accrual of 3+ weeks.

• PTO Buy-back, PTO Rollover, and PTO Donation Program.

• Wellness Reimbursement Program - $360 Annually.

• Employee Referral Bonus - Uncapped bonus potential.

• Tuition Assistance Program & Professional Association Reimbursement.

• Employee Assistance Program (provided by employer).

• Short & long-term disability coverage (provided by employer).

• Life Insurance (provided by employer).

• Remote work from a home office with a secure network.