• Process and coordinate outgoing referrals to specialists, imaging centers, physical therapy providers, and ancillary healthcare services • Keep patients informed of referral status, scheduling requirements, and necessary documentation • Verify insurance eligibility and confirm referral authorization requirements prior to submission • Build and maintain an up-to-date directory of providers and facilities accepting Medicaid and other insurance plans • Research in-network providers to guide patients toward appropriate referral placements and uninterrupted care • Document all referral activity accurately within the electronic medical record (EMR) system • Partner with physicians, medical assistants, and front office staff to facilitate timely care coordination • Follow up with external providers and facilities to confirm appointment scheduling and obtain outstanding reports • Monitor referral work queues to ensure timely completion and identify bottlenecks before they impact patient care • Serve as a resource for patients navigating referral logistics, insurance requirements, and next steps in their treatment • Uphold HIPAA standards and maintain strict confidentiality in all patient interactions • Proactively identify and resolve referral delays or obstacles to keep care on track

**Job Summary: ** Genesis Orthopedics & Sports Medicine is seeking a detail-oriented Remote Third-Party Liability (TPL) & Medical Records Specialist to oversee lien and settlement tracking, ensure timely medical records processing, and proactively identify relevant cases from multiple platforms. This individual will play a crucial role in maximizing revenue recovery from third-party claims and maintaining compliance with HIPAA and other healthcare regulations—all while adhering to our remote work policies. **Key Responsibilities: ** **Third-Party Liability (TPL) & Lien Processing: ** - Identify new and existing TPL cases from multiple platforms (e.g., Epic EMR, insurance portals, legal request systems, and attorney communications). - Prepare, send, and track lien letters for personal injury, auto accident, and other third-party liability cases. - Monitor case status to ensure timely communication regarding settlements, dismissals, or claim denials. - Work directly with attorneys, insurance companies, and adjusters to obtain necessary updates on case progress. - Maintain accurate documentation and track outstanding TPL balances within Epic EMR. - Ensure compliance with federal, state, and payer-specific TPL billing rules. - Assist in coordinating subrogation claims and reimbursement requests from health insurance carriers. **Medical Records ** - Process, track, and fulfill medical records requests from attorneys, insurers, government agencies, and patients. - Ensure requests are compliant with HIPAA, PHI privacy laws, and state medical records regulations. - Utilize Epic EMR to retrieve, review, and securely transmit medical records. - Identify relevant patient cases from multiple platforms to ensure all required records are processed accurately. - Handle subpoenaed records and coordinate responses to legal requests. - Maintain logs and tracking systems to ensure timely completion of requests. - Respond professionally to inquiries regarding record requests, fees, and processing timelines.

• Provide disease state, product, and ongoing therapy management education upon request, in consumer friendly language to the Rett community, which may include patients, caregivers, and/or other care team members. Caregiver engagement may take place before, during, and after therapy initiation, through various formats, including in-person, telephonic, and/or virtual interactions. • Determine individual needs of patients and caregivers and serve as an ongoing resource to provide appropriate education and resources accordingly, throughout the various stages of the patient journey. • Collaborates with and provides support for the entire assigned territory, which consists of multiple internal cross-functional partners (Marketing, Sales, Patient Access Team, Medical Affairs, Advocacy, and others), and may require coverage of multiple states. Supports and communicates educational opportunities with cross functional partners, as appropriate. • Possess expert knowledge and provide insights to internal stakeholders including, but not limited to, training leads, marketing partners, advocacy, medical and leadership, in an effort to develop tools and resources to address educational gaps, enhance disease state education, and therapy management strategies to patient families/caregivers. • Demonstrate deep knowledge of disease state, product, and Acadia Customer Support Programs, such as Hub-related and Patient Assistance Programs, and ambassador speaker programs, etc. • May moderate, lead and present caregiver speaker programs as needed, and attend community events within assigned territory. • Provide in-service to physician offices reactively, to educate about the Family Support Educator role, patient support resources provided to caregivers, pre and post enrollment in the program, and foster a dialogue between caregivers and healthcare providers. • Identify and execute on opportunities to provide leadership within the Family Support Educator team and with cross functional partners. • May provide formal mentorship and/or development opportunities with new Family Support Educator team members, and/or to cross functional colleagues interested in Patient Support Services. • Identify training and development opportunities related to Patient Support Services and the broader organization. • Ensures that all actions, both internally and externally, working on Acadia’s behalf are in compliance with all laws, regulations, policies and demonstrates Acadia values.

• Develop, execute and maintain high impact territory plans, including HCP and Investigator engagement plans in alignment with therapeutic area medical and scientific objectives with a focus on quality. • Support clinical development and research initiatives across development at the request of R&D. • Identify, gain access to, and develop professional customer centric based relationships with external experts in Immuno-Oncology within assigned geography. • Provide education relative to disease state, therapeutic landscape and Summit Therapeutics products across the product lifecycle to healthcare providers and researchers. • Participate, monitor, and provide insights to Summit from relevant scientific meetings in relevant geography. • Continuously maintain self-education on market issues/trends, product knowledge, and new therapeutic areas of interest as it pertains to specific business responsibilities. • Actively participate in relevant team meetings, organizational activities, and Country-driven medical affairs activities (e.g. advisory boards, masterclasses, roundtables). • Create, maintain, and collaborate in relationships with Cross-Functional partnerships to develop and execute Account plans.