Patient Therapy Access Specialist

The Opportunity

Our location in Plano, TX currently has an opportunity for a Patient Therapy Access Specialist (PTA).This is an in office 5 days a week position.Preferred hours 8am to 5pm. As a PTA Specialist you are responsible forfacilitating and assisting Abbott patients with the pre-certification, pre-determination and authorization process necessary as a prerequisite to perform various procedures or forms of therapy based on physician recommendation.

What You’ll Work On

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 as outlined by Abbott.

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, equipmentand 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.

Assist with appeals processes as and when necessary.

Required Qualifications

Associate's degree (± 13 years) , In Nursing / Home Health (LVN / LPN) or related field required ,or, an equivalent combination of education and work experience

General knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining toProspective and Retrospective Utilization Review.

Some experience in medical deviceor DME Billing a plus.

Proficient with Microsoft Office (Word & Excel specifically). Some 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 communication skills; verbal and written.

Previous experience in public speaking or presenting to small groups.

Attention to detail.

Ability to travel 5% of the time.

Excellent organization skills and ability to multi-task in a fast-paced environment.

Preferred Qualifications

Knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review.

Experience in medical device or DME Billing a plus

Proficient with Microsoft Office (Word & Excel specifically)

Medical billing software experience a plus

Knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding)

Knowledge of medical terminology

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

The base pay for this position is $20.05 – $40.15 per hour. In specific locations, the pay range may vary from the range posted.