Patient Access Appeals Case Manager (VA)

Responsibilities:

• Serve as the primary point of contact for patients, healthcare providers, and insurance companies regarding access and reimbursement for Noctrix therapy
• Guide patients through the reimbursement process, including benefit verification, prior authorization, claims processing, and financial assistance programs
• Educate patients on insurance coverage, out-of-pocket responsibilities, and available support resources
• Collaborate with healthcare providers to obtain required clinical documentation and supporting information for prior authorization and reimbursement requests
• Coordinate with insurance companies to ensure timely and accurate review of claims and authorization requests
• Stay current on payer policies, coverage criteria, reimbursement guidelines, and industry changes impacting patient access
• Maintain accurate and detailed patient records, case notes, and documentation within CRM and reimbursement systems
• Identify and resolve access or reimbursement barriers by partnering with internal cross-functional teams
• Provide exceptional customer service while addressing patient, provider, and payer inquiries