Patient Access Intake Specialist II

Additional Location(s):  N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.       

Shift hours: 7:00 AM - 4:00 PM or 8:00 AM - 5:00 PM

About the role:
The Patient Access Intake Specialist is responsible for the initial review of the patient case through submission to the insurance plan for prior authorization. Works closely with Intracept team members and external customers (physicians and patients) to ensure clean and timely submissions.

Your responsabilities will include:

• Confirms case information is complete and supports medical necessity. Obtains additional information from the physician or patient as needed.
• Follows up timely on assigned tasks to ensure optimal case progression.
• Communicates internally and externally to resolve case related issues.
• Submits prior authorization requests by phone or fax to the payer.
• Manages incoming faxes and correspondence, distributing to Case Managers in a timely and accurate manner.
• Prioritizes tasks according to urgency.
• Applies pressure on health plans that refuse to review based on negative or absent coverage policy for the procedure.
• Drafts all case related communication to physicians, patients and payers in a clear and concise manner.
• Documents all case activity and correspondence for cases in a timely manner to provide chronological details of case progress.
• Acts as a resource for fellow team members and new employees
• Demonstrated ability to navigate the prior authorization process with commercial and government payers.
• Strong ability to read clinical records and extract pertinent information for submission.
• Demonstrated knowledge of payer medical policies and criteria requirements.
• Ability to follow process and protocol and communicate when/if changes are needed.
• Ability to work within multiple software systems.
• Ability to adapt as the needs of the business change or evolve.
• Excellent verbal and written communication skills.
• Excellent interpersonal skills.

Required qualifications:

• 1 Year with Associate in Arts degree/diploma, or an equivalent combination of education/work experience
• Secure home office environment that ensures the protection of materials sensitive to HIPAA regulations.
• Must be willing to travel as needed (<5%).
• Minimum 2 years commercial insurance prior authorization experience. 

Preferred qualifications:

• Pain management or spine specialty preferred.

Requisition ID: 602436

Minimum Salary: $38272 

Maximum Salary: $65104 

The anticipated compensation listed above and the value of core and optional employee benefits offered by Boston Scientific (BSC) – see www.bscbenefitsconnect.com--will vary based on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be hired near the bottom or top of the anticipated salary range listed above.

Compensation for non-exempt (hourly), non-sales roles may also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).

Compensation for exempt, non-sales roles may also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements).

For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.

As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do – as a global business and as a global corporate citizen.

So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!

At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. 

Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identify, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status.  Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment.  Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements.   As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.