Patient Access Case Manager

Job Summary

Managing patient cases through the insurance authorization and appeal process, the remote Patient Access Case Manager will collaborate with the Interventional Spine team and external customers to navigate obstacles in patient access and reimbursement.

Key responsibilities

• Follow up on prior authorization requests and ensure proper review for medical necessity
• Draft appeal letters and participate in administrative law judge hearings on behalf of patients
• Document case activity and communicate effectively with internal and external stakeholders regarding patient access

Required qualifications

• 2+ years of experience in pain management or spine prior authorization roles, including reviewing clinical records and submitting requests
• Experience interpreting procedure denials and drafting appeals
• Proficiency in utilizing software systems for task management