Patient Access Appeals Case Manager at Noctrix Health
Worldwide
<p><span data-contrast="auto">Noctrix Health is redefining the treatment of chronic neurological disorders with clinically validated therapeutic wearables. Our team of medical device specialists, neuroscientists, and consumer electronics engineers is dedicated to delivering prescription-grade therapy with an outstanding user experience. We have pioneered the world’s first drug-free wearable therapy, clinically proven to alleviate symptoms in adults with drug-resistant Restless Legs Syndrome (RLS). Be part of our mission to transform healthcare, improve lives, and drive meaningful change with Noctrix Health.</span><span data-ccp-props="{"335551550":1,"335551620":1}"> </span></p> <p><span data-contrast="auto">The </span><strong><span data-contrast="auto">Patient Access Appeals Case Manager</span></strong><span data-contrast="auto"> is responsible for supporting patients through the denial and appeal process, coordinating with healthcare providers, insurance companies, and patients to ensure seamless access to our innovative DME device. This position will play a supportive role in ensuring the successful commercialization of our product by developing and executing reimbursement strategies, establishing relationships with payers, and navigating the complex healthcare reimbursement landscape.</span> <span data-contrast="auto"> </span><span data-ccp-props="{"335551550":1,"335551620":1}"> </span></p> <p><strong><span data-contrast="auto">Responsibilities:</span></strong><span data-ccp-props="{"335551550":1,"335551620":1}"> </span></p> <ul> <li><span data-contrast="auto">Support patients, healthcare providers, and insurance companies regarding access and reimbursement for our novel DME device </span><span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335559738":0,"335559739":0,"335559740":257}"> </span></li> <li><span data-contrast="auto">Collaborate with healthcare providers to obtain necessary documentation and clinical information for insurance claims and prior authorization requests </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Coordinate with insurance companies to ensure timely and accurate processing of claims and prior authorization requests </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Stay up to date with insurance policies, coverage criteria, and reimbursement guidelines to provide accurate information and assist in obtaining coverage for patients. </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Help to identify and address any access or reimbursement challenges, working closely with cross-functional teams to develop solutions </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Provide exceptional customer service to patients, healthcare providers, and insurance companies, addressing inquiries and resolving any access-related issues. </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Collaborate with internal stakeholders to develop training materials, tools, and resources for healthcare providers and patients to ensure a smooth access process </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Assess incoming denials and log in the database to identify trends in denials, new medical policies, as well as successful talk tracks and language used in successful appeals </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Continuously evaluate and enhance the commercial appeals process for efficiency and effectiveness </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Identify trends in appeals and provide insights to management for process optimization, and implement best practices and industry benchmarks to drive improvements in the appeals resolution workflow </span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Generate regular reports on appeal metrics, including volumes, resolution times, and outcomes</span><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></li> </ul> <p><strong><span data-contrast="auto">Requirements:</span></strong><span data-ccp-props="{"335551550":1,"335551620":1}"> </span></p> <ul> <li><span data-contrast="auto">BA/BS degree in business, healthcare or marketing fields required or equivalent experience</span><span data-ccp-props="{"335551550":1,"335551620":1}"> </span></li> <li><span data-contrast="auto">2+ years of healthcare sector (pharmaceutical and medical device) </span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":0,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">1+ years in medical device reimbursement involving DME products</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":0,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Experience leading projects and teams of reimbursement and billing professionals</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":0,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Excellent collaboration skills and can-do attitude</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":0,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Excellent presentation and communication skills, with a strong emphasis on written communication</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":0,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Excellent analytical abilities</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":730,"335559738":0,"335559739":0}"> </span></li> </ul> <p><span data-contrast="auto"><strong>Preferable</strong>:</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559685":0,"335559737":730,"335559738":0,"335559739":0}"> </span></p> <ul> <li><span data-contrast="auto">Experience in appeals, IRO, and ALJ process</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":730,"335559738":0,"335559739":0}"> </span></li> <li><span data-contrast="auto">Experience with Insurance Complaints and State Fair Hearings</span><span data-ccp-props="{"134233117":false,"134233118":false,"335551550":1,"335551620":1,"335559737":730,"335559738":0,"335559739":0}"> </span></li> </ul>
Apply Now
