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Patient Access Appeals Case Manager (VA)

2 weeks, 5 days ago
Anywhere
Full-time
Senior
Operations Specialist
Customer and Technical Support
CRM
Apply Now
Noctrix Health

Noctrix Health

Noctrix Health is a leading medical equipment manufacturing company that specializes in developing clinically validated wearable therapeutics for the management of chronic neurological disorders. Their revolutionary wearable therapy offers a powerful a...

Health Care Providers & Services
11-50
Founded 2018
View All Jobs 3

Description

  • Serve as the primary point of contact for patients, healthcare providers, and insurance companies on access and reimbursement matters.
  • Guide patients through benefit verification, prior authorization, claims processing, reimbursement, and financial assistance programs.
  • Educate patients on insurance coverage, out-of-pocket responsibilities, and available support resources.
  • Work with healthcare providers to obtain clinical documentation and supporting information for authorization and reimbursement requests.
  • Coordinate with insurance companies to support timely and accurate review of claims and authorization requests.
  • Stay current on payer policies, coverage criteria, reimbursement guidelines, and industry changes affecting patient access.
  • Maintain accurate patient records, case notes, and documentation in CRM and reimbursement systems.
  • Identify and resolve access or reimbursement barriers by partnering with internal cross-functional teams.
  • Provide customer service for patient, provider, and payer inquiries.
  • Support the development of educational materials, tools, and resources that streamline the access process.

Requirements

  • Bachelor's degree in Business, Healthcare Administration, Marketing, or a related field preferred.
  • Minimum of 5 years of experience in the healthcare industry, including pharmaceutical, medical device, or reimbursement-focused roles.
  • Minimum of 2 years of medical device reimbursement experience involving DME products.
  • Experience navigating commercial, Medicare, and government payer reimbursement processes.
  • VA and Medicare reimbursement experience preferred.
  • Strong understanding of benefit verification, prior authorizations, appeals, and reimbursement workflows.
  • Excellent verbal and written communication skills.
  • Strong analytical and problem-solving abilities.
  • Demonstrated ability to collaborate effectively across internal and external stakeholder groups.
  • Strong organizational skills with the ability to manage multiple patient cases simultaneously.
  • Experience with CRM systems and reimbursement platforms preferred.
  • Experience supporting novel or emerging medical device therapies preferred.
  • Experience negotiating single-case agreements and managing complex reimbursement scenarios preferred.
  • Familiarity with patient access programs and financial assistance resources preferred.
  • Prior experience in a high-growth medical device or healthcare organization preferred.

Benefits

  • Base pay of $70,000 to $85,000 plus bonus.
  • Full-time position.
  • Opportunity to work on a clinically validated, prescription-grade therapy with direct patient impact.
  • Role supporting a mission-driven company focused on improving lives for people with Restless Legs Syndrome.

Interested in this position?

Apply directly on the company website

Apply Now

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