Patient Therapy Access Specialist

Abbott is a global healthcare leader that helps people live more fully at all stages of life.

Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals, and branded generic medicines.

Our 109,000 colleagues serve people in more than 160 countries.

For years, Abbott’s medical device businesses have offered technologies that are faster, more effective, and less invasive.

Whether it’s glucose monitoring systems, innovative therapies for treating heart disease, or products that help people with chronic pain or movement disorders, our medical device technologies are designed to help people live their lives better and healthier.

Every day, our technologies help more than 10,000 people have healthier hearts, improve quality of life for thousands of people living with chronic pain and movement disorders, and liberate more than 500,000 people with diabetes from routine fingersticks.

Abbott Vascular provides innovative, minimally invasive and cost-effective products for treatment of vascular disease.

Our extensive portfolio includes drug-eluting stents, bare metal stents, guide wires, balloon dilatation catheters, imaging catheters and software, vessel closure devices and peripheral stents Our location in Sylmar, CA, currently has an opportunity for a Patient Therapy Access Specialists.

WHAT YOU’LL DO: You will be responsible for facilitating and assisting Abbott patients with the pre-certification, determination and authorization process necessary as a prerequisite to perform various procedures or forms of therapy based on physician recommendation.

Assist with multiple levels of appeal in the event of initial coverage denial.

Forward authorized confirmation for procedure to designated patient provider.

Provide regular updates to the patient and their designated provider regarding patient case status and next steps.

• Responsible for managing multiple cases simultaneously within specific time frames.

• Follow all policies and procedures related to performing the job role adhering to all data use, storage and privacy policies as outlined by Abbott.

• Verify benefits, complete authorization requests promptly.

• Timely follow up for requested authorizations.

• For each procedure, audit required clinical documents for completeness and accuracy.

• Obtain authorization for the facility, equipment and physician to perform various procedures from the insurance carrier.

• Work with key provider contacts to obtain required clinical information for authorizations.

• Work with respective carrier’s utilization review department to obtain appropriate authorizations.

• Assist with appeals processes as and when necessary.

• Assist with the training of patients and their designated providers on pre-authorization processes and requirements, in person or by phone.

• Work individually and in a team environment to educate assigned Field Territory Managers and Clinical Specialists.

EDUCATION AND EXPERIENCE YOU’LL BRING: Associates Degree In Nursing/Home Health (LVN/LPN) or related field required or an equivalent combination of education and work experience Minimum 2 years in a utilization (medical approval) environment or similar work experience.

General knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review.

Some experience in medical device or DME Billing a plus.

Proficient with Microsoft Office (Word & Excel specifically).

Some knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding).

Ability to accurately meet required time frames/deadlines.

Ability to work as a team player and share workloads with other team members.

Excellent communication skills; verbal and written.

Previous experience in public speaking or presenting to small groups.

Attention to detail.

Ability to travel 5% of the time.

Excellent organization skills and ability to multi-task in a fast-paced environment.

WHAT WE OFFER : At Abbott, you can have a good job that can grow into a great career.

We offer:
• A fast-paced work environment where your safety is our priority
• Training and career development, with onboarding programs for new employees and tuition assistance
• Financial security through competitive compensation, incentives and retirement plans
• Health care and well-being programs including medical, dental, vision, wellness and occupational health programs
• Paid time off
• 401(k) retirement savings with a generous company match
• The stability of a company with a record of strong financial performance and history of being actively involved in local communities Learn more about our benefits that add real value to your life to help you live fully: www.abbottbenefits.com Follow your career aspirations to Abbott for diverse opportunities with a company that provides the growth and strength to build your future.

Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com , on Facebook at www.facebook.com/Abbott and on Twitter AbbottNews and AbbottGlobal.

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