Patient Access Specialist - US Healthcare Account
REMOTE (WFH) | FULL-TIME | 9PM-6AM PHT (FIXED SCHEDULE)
Neolytix is looking for a Healthcare Associate who already knows the prior authorization world inside and out — in a healthcare BPO, a hospital, a clinic, a payer-services team, or a revenue cycle department — and can step in already knowing how the work goes.
WHAT YOU WILL DO:
Own the authorization lifecycle
- Submit authorization requests through payer portals and other approved channels, and track them through to resolution.
- Collect and validate clinical documentation and patient information needed to support each request.
- Manage payer follow-up, status tracking, escalations, and deadlines so nothing slips through the cracks.
- Support peer-to-peer reviews, denials, reconsiderations, and appeals when a request needs a second look.
- Work confidently across EHR/EMR systems, payer portals, communication tools, and multi-queue work environments.
- Enter data accurately, spot errors before they become problems, complete forms correctly the first time, and keep documentation audit-ready.
- Take inbound calls from healthcare professionals — nurses, physicians, and office staff — with authorization-related questions, and professionally assist insurance members who need help or clarification.
- Explain billing, benefits, and account details to callers clearly and professionally, verifying caller and account information against records before processing any request.
- Manage a high-volume, multi-queue workload with strong organization, time prioritization, and SLA awareness.
- Document every interaction completely and accurately, and resolve issues patiently — including with callers who need extra time or a simpler explanation.
- Maintain confidentiality and professionalism at all times, and complete required HIPAA and security training.
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