Abbott Senior Patient Therapy Access Assistant (Case Manager) in Plano, Texas

At Abbott, we're committed to helping you live your 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, 94,000 of us are working to help people live not just longer, but better, in the more than 150 countries we serve. Please note that candidates need to be eligible to work in the U.S. without Abbott sponsorship.

JOB DESCRIPTION:

We are seeking an experienced, high caliber Patient Therapy Access Assistant. This position is responsible for obtaining pre-certification, determination and authorization for the facility, equipment and physician's fees to perform spinal cord stimulation based on physician recommendation. Forward authorized confirmation for procedure to facility, physician and representative.

Impact this role will have on Abbott:

  • Responsible for managing multiple cases simultaneously within specific time frames

  • Verify benefits, complete authorization requests promptly

  • Timely follow up for requested authorizations

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

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

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

  • Work with respective carrier’s 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 Specialist

Your experience(s), education and knowledge will further expand Abbott’s marketplace success:

  • Associate degree in Nursing/Home Health or related field. LVN/LPN strongly preferred.

  • 2 plus years of experience in a utilization (medical approval) environment or similar work experience

  • Experience in medical or DME Billing a plus

  • Proficient with Microsoft Office (Word & Excel specifically) medical billing software a plus

  • Knowledge of current CPT codes and familiarity with ICD-9CM (diagnosis coding)

  • General knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining to

  • Prospective and Retrospective Utilization Review.

JOB FAMILY:

Market Access

DIVISION:

ASJM Abbott St. Jude Medical

LOCATION:

United States > Texas : 6600 Pinecrest

ADDITIONAL LOCATIONS:

WORK SHIFT:

Standard

TRAVEL:

Yes, 5 % of the Time

MEDICAL SURVEILLANCE:

No

SIGNIFICANT WORK ACTIVITIES:

Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day), Keyboard use (greater or equal to 50% of the workday)

Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.

EEO is the Law link - English: http://webstorage.abbott.com/common/External/EEO_English.pdf

EEO is the Law link - Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf

Abbott is about the power of health. For more than 125 years, Abbott has been helping people reach their potential — because better health allows people and communities to achieve more. With a diverse, global network serving customers in more than 150 countries, we create new solutions — across the spectrum of health, around the world, for all stages of life. Whether it’s next-generation diagnostics, life-changing devices, science-based nutrition, or novel reformulations, we are advancing some of the most innovative and revolutionary technologies in healthcare, helping people live their best lives through better health.

The people of Abbott come to work each day with relentless energy, enthusiasm and a promise to enhance the health and well-being of millions of people. They push the boundaries to help manage and treat some of life’s greatest health challenges.

We invite you to explore opportunities at Abbott , to see if your talents and career aspirations may fit with our openings. An equal opportunity employer, Abbott welcomes and encourages diversity in our workforce.

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