Abbott Case Manager, Patient Therapy Access Department in Plano, Texas
At Abbott, we're committed to helping people live their best possible life through the power of health. For more than 125 years, we've brought new products and technologies to the world -- in nutrition, diagnostics, medical devices and branded generic pharmaceuticals -- that create more possibilities for more people at all stages of life. Today, 99,000 of us are working to help people live not just longer, but better, in the more than 150 countries we serve.
Responsible for obtaining prior authorizations for the physician, facility and equipment fees for designated therapy. Providing education, support and reimbursement training to customers including field sales team.
Responsible for managing multiple cases simultaneously within specific time frames
Providing education, support and reimbursement training to customers
Verification of benefits
Clinical audit for completeness and accuracy for designated therapy for respective carrier
Timely follow up
Attention to detail
Obtain authorizations for the facility, equipment and physician’s fees
Work with key customers to obtain required clinical information for authorizations
Work with respective carriers’ utilization review department to obtain appropriate authorizations
Work within established guidelines when necessary to process appeal for denied requests
Act as subject matter expert to physicians and facilities for correct claim coding
Work in a team environment to educate and support assigned Field Territory Managers and Clinical Specialists
Experience & Training :
Minimum of 2 plus years experience in a utilization (medical approval) environment or similar work experience
High school degree or equivalent, 4 year degree highly preferred in reimbursement or nursing.
Experience in medical billing a plus
Proficient with Microsoft Office (Word & Excel specifically) medical billing software a plus
Sound working knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding)
Excellent organizational skills and ability to multi-task in a fast paced environment
Ability to accurately meet required time frames/deadlines
Ability to work as a team player and share workloads with other team members
Other Skills/Characteristics :
Cardiology coding / billing
General knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review
An Equal Opportunity Employer
Abbot welcomes and encourages diversity in our workforce.
We provide reasonable accommodation to qualified individuals with disabilities.
To request accommodation, please call 224-667-4913 or email email@example.com