Patient Services Coordinator

Company: EVERSANA Company
Location: Chesterfield
Posted on: March 19, 2023

Job Description:

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Our employees are tasked with delivering excellent business results through the efforts of their teams. These results are achieved by:

* Facilitate the patient consented Medical Necessity Appeals process.
* Identify and report issues that require additional investigation, validate discrepancies, and ensure appropriate follow up.
* Assist in the coordination, submission and updates of patient consented medical necessity appeals.
* Collaborate with the Medical Necessity Appeals team to resolve any appeals related issues.
* All other duties as assigned

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

EXPECTATIONS OF THE JOB:

* Review cases assigned to appeals for completeness and assign to Clinical Appeals Nurse as appropriate
* Monitor Fed-ex delivery of appeals to insurance companies and follow up to ensure timely processing
* Provide client feedback as requested on appeals processing timelines.

The above list reflects the general details necessary to describe the expectations of the position and shall not be construed as the only expectations that may be assigned for the position.

An individual in this position must be able to perform the expectations listed above successfully.

MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES:

The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

* High School Diploma or GED
* 1 year of administrative experience, preferably in an insurance setting
* Excellent verbal, written, and proofreading skillsAbility to prioritize and manage multiple tasks
* Self-directed; reliable; detail oriented
* Working knowledge of Microsoft Word, Excel and Outlook
* Superior customer service and typing skills

PREFERRED QUALIFICATIONS:

* Reimbursement and Pharmacy experience

PHYSICAL/MENTAL DEMANDS AND WORKING ENVIRONMENT:

The physical and mental requirements, along with the work environment characteristics described here, are representative of those an individual encounters while performing the essential functions of this position.

Office: While performing the essential functions of this job the employee is frequently required to reach, grasp, stand and/or sit for long periods of time (up to 90% of the shift), walk, talk and hear; occasionally required to lift and/or move up to 25 pounds. The noise level in the work environment is usually moderately quiet, with frequent interruptions and multiple demands.

Keywords: EVERSANA Company, Chesterfield , Patient Services Coordinator, Other , Chesterfield, Missouri