Treatment Access Specialist
Company: TMS Health Partners
Location: San Rafael
Posted on: March 17, 2023
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Job Description:
In our high-volume multi-site psychiatric practice, the
Treatment Access Specialist (TAS), would act as a reimbursement and
care advocate for any patients with an Interventional Treatment
Path, assisting them with any pre- and post-treatment care
coordination, awareness, benefit questions and authorization
submission/approval. The Treatment Access Specialist will work
closely with patients, providers, and insurance companies to
support member access to appropriate quality and cost-effective
care. Interventional Treatments managed by the Treatment Access
Specialist include: Transcranial Magnetic Stimulation (TMS) - a
non-drug therapy used to treat patients with drug-resistant
depression and Esketamine (ESK) via SPRAVATO - a prescription
medicine, administered by nasal spray, and used along with an
antidepressant to treat Adults with treatment-resistant depression
(TRD). Respond and access more complex TMS/ESK cases and account
specific requests while using appropriate insurance screening
criteria knowledge and clinical judgmentEducate and support the
individual and their family through telephonic assessment,
tele-video and in-person consultationsComplete the necessary prior
authorizations and correspondence required by insurance companies
to approve patients for TMS/ESK therapyConduct assessments to
identify individual needs and work with the provider to execute a
financial reimbursement plan that matches the goals outlined in the
treatment care planParticipates in cross-functional teams projects
and initiativesTrack patient progress verify insurance coverage
through benefits investigations, schedule patients and obtain prior
authorization or pre-certificationCoordinates care across the
continuum (Front Desk, Technicians, Provider, Denial Management
Specialist) to assure appropriate utilization of clinical and
community resourcesParticipates on a team for data collections,
health outcomes reporting, clinical audits, and programmatic
evaluation related to initiativesIn conjunction with the practice
team, identifies patients at risk for poor outcomes or patients
experiencing poor coordination of services who would benefit from
more intensive follow-upDraft and submit appeals as needed that
require careful wording Bachelor's Degree required, or equivalent
combination of education, training, and relevant experience Strong
customer service skills and exceptional phone presence Ability and
desire to adapt and learn quickly Proficient with Microsoft Word,
Excel, and essential computer capabilities. Excellent
written/verbal skills along with interpersonal skills with
physicians, patients, co-workers, referral sources, and leadership
Minimum two years' experience in a medical office environment
center is preferred with familiarity with medical terminology
Experience obtaining prior authorizations for medical services,
preferred Ability to interact with potential patients, clinic
staff, physicians, insurance companies and other support
departments in a professional manner Ability to multi-task with
high degree of attention to detail and bring tasks to completion
Must respect and adhere to office guidelines and use good judgment
regarding patient records and confidentialityThis is a hybrid
role.Pay range: $24.00 per hourThis information reflects the
anticipated base salary range for this position based on current
national data. Minimums and maximums may vary based on location.
Actual pay will be adjusted based on an individual's skills,
experience, education, and other job-related factors permitted by
law. The employee may be eligible for bonuses and other forms of
compensation.
Keywords: TMS Health Partners, San Rafael , Treatment Access Specialist, Other , San Rafael, California
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