Patient Access Lead, Full Time- Remote

Infusion PA; United States; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Bonus plan target 5% annually (basedon

Wellness reimbursement program - $360

Tuition assistance & professional assn

Employee assistance program

Short & long-term disability

Life insurance

Job summary

Vivo Infusion is seeking a Patient Access Lead to manage referrals, verify insurance benefits, and ensure timely approvals from a home office in the United States. You will oversee the Patient Access Specialists, review eligibility, and maintain up-to-date approvals and financial documents.

You will collaborate with the Patient Navigator and Medical Records teams, oversee audits, train staff, and support leadership in process improvements while upholding HIPAA compliance and data accuracy.

Qualifications

• 3+ years in high-volume insurance verification, benefits and eligibility/authorizations.
• 2 years of medical billing and authorizations or managing physician referrals.
• 1 year in a customer service or patient-facing role.

Responsibilities

• SME in all Patient Access functions and processes.
• Proficient in applicable systems, programs, resources, and tools.
• Assists with Patient Access functions as needed per business demands.
• Maintain knowledge of CPT, HCPCS, and ICD-10 codes.
• Communicate with insurers, clinics, patients, and staff regarding eligibility and referrals.
• Train new and existing employees and perform QA audits.
• Monitor workload and coordinate coverage to ensure timely referrals.

Skills

Insurance verification

HIPAA knowledge

Customer service

Excel

Education

High school diploma or equivalent

Associate or bachelor’s degree preferred

Tools

Microsoft Office

Job description

• Bonus Plan Target: 5% Annually (Based on performance)
• Wellness Reimbursement Program - $360 Annually
• Tuition Assistance Program & Professional Association Reimbursement
• Employee Assistance Program (Employer-provided)
• Short & long-term disability (Employer-provided)
• Life Insurance (Employer-provided)

Employment Type, Schedule, FLSA Status:

• Full-time
• Position Scheduled:
  • Monday-Friday | Flexible hours 7:00am - 7:00pm EST
• Non-Exempt

Reports to:

Patient Access Manager

Location:

The Patient Access Specialist will work remotely from a home office with a secure network. Only candidates residing in the states below at the time of employment will be able to be considered. Travel with Vivo equipment is not permitted without prior approval.

As the Patient Access Lead you will support the Patient Services department and facilitate the infusion admission process. Individuals in this role will collaborate with and support the Patient Access Managers by ensuring the thorough and accurate processing of referrals and updated orders to include insurance eligibility and benefits verifications, prior approvals, and data entry. In addition, Patient Access Leads support continuity of care for existing patients by ensuring that eligibility, current financial documents, and prior approval renewals are reviewed and maintained prior to patient appointments. The lead is responsible for prioritizing, organizing, and delegating tasks to the Patient Access Specialists; completing audits and reviews; training new and existing employees; and handling escalated needs and calls.

For this position, applicants must have the following experience:

• 3+ years of experience working in high-volume insurance verification, benefits, and eligibility/authorizations.
• 2 years of medical billing and authorizations or managing physician referrals.
• 1 year experience working in a customer service or patient facing role.

Primary Responsibilities:

• Subject Matter Expert (SME) in all aspects of the Patient Access functions, responsibilities, and processes & procedures.
• Proficient in all applicable systems, programs, resources, and tools.
• Assists with all Patient Access functions as needed per business demands.
• Knowledgeable of all Patient Services roles and able to assist workload as needed.
• Maintain working knowledge of insurance contracts and exclusions.
• Maintain knowledge of applicable CPT, HCPCS, and ICD-10 codes
• Maintain familiarity with drug copay assistance program requirements to determine whether a patient meets base eligibility conditions.
• Uphold and promote adherence to HIPAA guidelines.
• Generate and manipulate Excel spreadsheets to sort, condense, and prioritize data.
• Demonstrate exceptional written and verbal communication skills when interacting with insurances, referring office staff, patients, and internal & clinical staff.
• Communicate and maintain contact with the Patient Navigator, Medical Records Review, and Patient Resources teams regarding patient accounts, referral documentation, insurance and coordination of benefits concerns, patient financial documents, prior approvals, referrals, etc.
• Utilize appropriate templates, naming conventions, formats, and email distribution lists for system notations and email & task communication.
• Conduct training for new and existing employees, to include onboarding and refresher training sessions.
• Acts as a key point of contact for the Patient Access team
• Assists Patient Access Managers in driving team goals, guidelines, and expectations.
• Monitor team workload and productivity.
• Complete regular Quality Assurance (QA) audits.
• Responds to escalations and concerns.
• Makes recommendations for improvements to established processes and procedures.
• Run and build daily, weekly, monthly, and ad hoc reports for review and assignment.
• Facilitate schedule review reports, authorization tracking, and other routine reports.
• Assist and support leadership in communication regarding process changes, function and responsibility coverage, and guidelines updates.
• Assist with managing the workload and coordinates coverage assistance when necessary to ensure that referrals and orders are handled in a timely manner.
• Identify and elevate team performance issues and communicate concerns to manager.
• Collaborates with manager in educating team members toward improvement and provides peer feedback as directed.
• Act as key participant and co-presenter on weekly calls as outlined by manager

Secondary responsibilities:

• Facilitate month-end in any facet
• Maintain patient records and confidentiality via the electronic Medical Record System
• Develops an effective communication mechanism for the Home Office to promote a positive image with clinics, patients, visitors, co-workers, physicians, office personnel, and external agencies
• Demonstrates the Vivo culture
• Attends necessary meetings related to department activities
• Performs other duties as assigned

Qualifications:

• Minimum 3+ years of related prior work experience required, preferably in admission, scheduling and medical insurance within the healthcare industry.
• Proven competencies can take precedence over prior work experience.
• High school graduate or equivalent; associates or bachelor’s degree preferred.
• Proficient (intermediate level of application) with all Microsoft Office Products programs.
• Advanced knowledge of insurance, accounting, medical billing, HIPAA, Medicare/Medicaid, medical abbreviations and terminology, required.
• Must possess outstanding communication and interpersonal skills, be able to communicate professionally and effectively with other staff members, patients, vendors and physicians, and is fluent in written and spoken English.
• Experience supporting multiple managers/supervisors.
• Prior experience working with sensitive information and maintaining confidentiality.
• Travel minimal in this role but can be up to 10%.

Education and Experience

• Minimum 3+ years of related prior work experience required, preferably in admission, scheduling and medical insurance within the healthcare industry.
• Proven competencies can take precedence over prior work experience.
• High school graduate or equivalent; associates or bachelor’s degree preferred.Proficient (intermediate level of application) with all Microsoft Office Products programs.
• Advanced knowledge of insurance, accounting, medical billing, HIPAA, Medicare/Medicaid, medical abbreviations and terminology, required.
• Must possess outstanding communication and interpersonal skills, be able to communicate professionally and effectively with other staff members, patients, vendors and physicians, and is fluent in written and spoken English.
• Experience supporting multiple managers/supervisors.
• Prior experience working with sensitive information and maintaining confidentiality.
• Travel minimal in this role but can be up to 10%.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Who We Are:

The Vivo Infusion team is focused on providing patients with the highest quality of care in a comfortable, safe, and convenient setting! Vivo is a national company with locations in 15 states, providing opportunities for growth and advancement as well as competitive benefits that support what matters most to you.

Our highly trained medical professionals are dedicated to delivering a safe, comfortable, and affordable solution for our patients. We offer an array of advanced therapeutics and provide personalized care for every patient.

We are passionate about providing high-quality patient care, relationships with our referring Providers, and nurturing our company culture!

Vivo Infusion has received The Gold Seal of Approval® from The Joint Commission.

The Joint Commission Gold Seal of Approval is a nationally recognized distinction voluntarily earned by a select set of healthcare providers.

An organization that achieves The Gold Seal of Approval® shows its commitment to holding itself accountable to a high bar for quality and safety for those they serve.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

While performing the duties of this job, the employee is regularly exposed to work near moving mechanical parts (medical equipment and machinery). The employees may be exposed to fumes or airborne particles and toxic or caustic chemicals. The noise level in the work environment is usually moderate.

Specific vision abilities required by this job include close vision, color differentiation, distance vision, peripheral vision, depth perception and ability to adjust focus. While performing the duties of this job, the employee is required to stand; walk and talk, hear and smell.

Requires excellent visual acuity and manual dexterity. The employee is frequently required to use hands to finger, handle, or feel and reach with hands and arms. He/she is frequently required to sit; stoop, kneel, bend, crouch, or crawl.

The employee may be required to use safety equipment, PPE (personal protective equipment) that may include but not be limited to face shield or goggles, non-slip shoes, gloves, mask, and other protective garments and equipment.

RECRUITMENT PRIVACY STATEMENT | Notice to All Applicants:

Vivo Infusion is an Equal Opportunity Employer.

Applicants will never be asked to provide personal identification information (e.g., SSN, Driver’s License, Passport) or financial information (e.g., Banking Information) during the application and Interviewing process.

We may request:

• Contact details such as name, address, email address, and phone number.
• Employment history including previous employers and job titles/positions.
• Background information including academic/professional qualifications, job qualifications, education, certifications or licenses, details included in your CV/resume, transcripts, and employment references.
• Nominated references including their name, contact details, employer, and job role.
• Proof of your eligibility to work in the US.
• Desired salary.

If you have any questions or concerns about this Recruitment Privacy Statement or how we handle your personal data, please contact us at 855.478.1528 or emailing [e-mail]