Job Description

Exciting Patient Assistance Specialist Opportunity! Are you ready to take your career to the next level? At Converge Medical Technology, we provide game-changing technology with empowering personalized patient services as part of our supervised physical therapy program. The Patient Assistance Specialist is responsible claims processing for the day-to-day operations of patient account verification, authorization, billing and follow up for the commercial line of business. Also responsible for communicating benefits to the patient and qualifying and setting up patients with financial assistance.

Key Responsibilities:

• Coordinate the DME-related administrative aspects of patient care for individuals with commercial insurance coverage.
• Verify insurance benefits, determine coverage limits, and identify required medical documentation for authorization purposes.
• Communicate directly with patients regarding: Deductibles, coinsurance, and copays, Financial qualification for company hardship programs, Coordination and clarification of insurance benefits, Updates to coverage and insurance information.
• Manage and respond to incoming referrals, maintaining accurate records of inquiries and follow-up activities.
• Use Salesforce and other internal systems to complete daily tasks in alignment with standard operating procedures.
• Handle a high volume of inbound and outbound calls, serving as a liaison between insurance companies, patients, and sales representatives.
• Facilitate the processing of prior authorizations, appeals, and insurance updates.
• Provide timely, accurate information and guidance to sales representatives, including payer-specific coverage criteria.
• Research required information using available resources to support referral processing and case updates.
• Escalate urgent or complex issues to the Intake Manager to ensure timely resolution.
• Perform other duties as assigned.

Qualifications:

• 1-year customer service experience preferably with insurance verification or DME experience.
• 1-2 years of prior authorization experience in a DME or clinical setting.
• Experience with Commercial insurance plans.
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.
• Ability to apply concepts of basic algebra and geometry.

Location: In Person in Austin, TX

Pay Range: $21-$23/hr

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