Patient Access & Reimbursement Specialist — Growth Role

PRIA Healthcare Management LLC; Farmington (CT); On-site; USD 30,000 - 39,000; Full time

Benefits offered by this job

Medical/Dental/Vision Insurance

401(k) Plan with company match

Paid Time Off (PTO)

Paid holidays (federal & floating)

Employee Assistance Program (EAP)

Professional development opportunities

Internal training programs

Job summary

PRIA Healthcare Management LLC is seeking a Patient Access Specialist to support reimbursement and patient access for technologies and procedures. The role involves benefits verification, prior authorizations, and appeals across physicians, billing staff, hospitals, and ambulatory centers.

You will manage case loads, perform data entry in system databases, and maintain Salesforce records for reporting. The position emphasizes accurate documentation and adherence to SOPs as part of the patient

Qualifications

• High school diploma or equivalent; Associate’s degree preferred.
• Minimum of 2 years of experience in a healthcare setting, preferably in authorization or billing.
• Understanding of medical terminology and insurance processes.
• Excellent communication and organizational skills.
• Ability to work independently and handle multiple tasks.

Responsibilities

• Manage a case load for an assigned program.
• Data entry and review of new patient cases into system database.
• Communicate with physician’s office and their staff regularly.
• Maintain accurate and up-to-date records within the Salesforce platform to ensure accurate reporting to clients.
• Complete full patient access process as outlined by program SOP including but not limited to: analyze medical necessity criteria per payer policy.
• Review multiple insurance policies to define medical necessity criteria to support device/procedure(s).
• Benefits verification and payer discovery.
• Prior Authorization / pre-service review submissions, pre and post service appeal submissions.
• Ensure all documents developed to support an appeal are accurate, consistent, up to date, and in compliance with SOPs.

Skills

Healthcare experience

Authorization/billing knowledge

Communication skills

Independent work

Organizational skills

Education

High school diploma

Associate’s degree preferred

Tools

Salesforce

Data entry

Job description

PRIA Healthcare Management LLC is seeking a Patient Access Specialist to support reimbursement and patient access for technologies and procedures. The role involves benefits verification, prior authorizations, and appeals across physicians, billing staff, hospitals, and ambulatory centers.

You will manage case loads, perform data entry in system databases, and maintain Salesforce records for reporting. The position emphasizes accurate documentation and adherence to SOPs as part of the patient