Data Entry Specialist

About the role

SD Solutions is looking for a Patient Advocacy Audit Specialist on behalf of HealthTech Client #1. This quality assurance role reviews and audits work performed by Patient Advocates, ensuring tasks align with program requirements and client expectations. The role focuses on identifying revenue recovery opportunities and sharing actionable findings with leadership. It does not involve patient-facing activities.

Audit responsibilities center on PAP and Copay program workflows, including completed enrollments, claims, and medication orders.

Responsibilities

• Review rejected tasks in MAP daily and verify that the correct rejection code was applied.
• Identify rejection code errors where an enrollment, order, or claim remains actionable, distinguishing miscoded rejections from true terminal rejections.
• Share rejection code errors with the Director of Patient Advocacy, with enough detail for Managers to take corrective action.
• Prioritize findings with active recovery potential to minimize revenue leakage and enable advocates to re-engage eligible patients.
• Evaluate whether rejection reason codes were applied correctly, snooze protocols were followed, and tasks were completed within required timeframes.
• Recognize patterns such as out-of-retro occurrences, premature closures, and snooze misuse, and flag findings for Manager review.

Benefits

SD Solutions is a staffing company operating globally. Contact us to get more details about the benefits we offer.

Datos clave

• The role audits Patient Advocates’ work for accuracy and alignment with program requirements and client expectations.
• Audit workflows include PAP and Copay enrollments, claims, and medication orders.
• The role does not perform patient-facing activities.