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Patient Advocacy Audit Specialist
Location
Philippines
Posted
1 day ago
Salary
0
Seniority
Senior
Job Description
Patient Advocacy Audit Specialist
SD Solutions
• Review and audit the work performed by Patient Advocates • Ensure patient advocacy tasks are completed accurately and align with program requirements • Identify revenue recovery opportunities and surface actionable findings to leadership • Review rejected tasks in MAP on a daily basis to verify correct rejection code applied • Identify rejection code errors where underlying enrollment, order, or claim is actionable • Surface identified rejection code errors to the Director of Patient Advocacy • Prioritize findings with active recovery potential to minimize revenue leakage • Track patterns in rejection code misuse to identify training gaps • Document and track quality findings to support improvement of workflows and services • Prepare audit finding reports and submit structured feedback to the Director of Patient Advocacy • Participate in calibration sessions to align audit standards with operational expectations.
Job Requirements
- High school diploma or equivalent required; associates degree or higher preferred
- Prior experience in a healthcare, patient access, billing, or quality assurance environment strongly preferred
- Familiarity with patient assistance programs, copay support, or pharmaceutical access programs is a plus
- Experience with healthcare Electronic Health Records (EHRs) such as EPIC, Cerner, Meditech, or Allscripts preferred
- Proficient computer skills with advanced Microsoft Office capabilities (assessment may be administered)
- Ability to navigate multiple computer systems and platforms simultaneously
- Basic knowledge of medical terminology preferred
- Experience with audit tools, quality tracking systems, or case management platforms is a plus
- Exceptional attention to detail with a sharp eye for errors and inconsistencies
- Strong analytical and critical thinking skills
- Clear written and verbal communication skills for documenting and reporting findings
- Ability to work independently with minimal supervision in a remote environment
- Organizational discipline and ability to manage a high volume of audit cases
- Flexibility to adapt to evolving workflows, program changes, and shifting priorities.
Benefits
- Contact us to get more details about the benefits we offer.
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• Responsible for reviewing and auditing the work performed by Patient Advocates • Ensure that patient advocacy tasks are completed accurately in alignment with program requirements • Identify revenue recovery opportunities and surface actionable findings to leadership • Support audit responsibilities centered on PAP and Copay program workflows • Review completed enrollments, claims, and medication orders for accuracy • Evaluate rejection reason codes and track patterns in misuse for improvement • Document and track quality findings to support identification of improvement opportunities • Prepare audit finding reports and submit structured feedback


