Treatment Access Specialist

Company: TMS Health Partners
Location: San Rafael
Posted on: March 17, 2023

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