On behalf of Atlas Health, SD Solutions is looking for a talented Patient Advocacy Audit Specialist to join the team.
The Patient Advocacy Audit Specialist is a quality assurance role responsible for reviewing and auditing the work performed by Patient Advocates. This role ensures that patient advocacy tasks are completed accurately and in alignment with program requirements and client expectations, with a primary focus on identifying revenue recovery opportunities and surfacing actionable findings to leadership. The Audit Specialist does not perform patient-facing activities but instead serves as a quality control function supporting the Patient Advocacy team.
SD Solutions is a staffing company operating globally. Contact us to get more details about the benefits we offer.
Supporting audit responsibilities are centered on PAP and Copay program workflows, including reviewing completed enrollments, claims, and medication orders for accuracy and task completion. This includes evaluating whether correct rejection reason codes were applied, snooze protocols were followed appropriately, and tasks were completed within required timeframes. Auditors are expected to recognize common miss patterns — such as out-of-retro occurrences, premature closures, and snooze misuse — and flag these findings for Manager review.
Responsibilities:
MAP Rejection Code Review & Revenue Recovery.
Review rejected tasks in MAP on a daily basis to verify that the correct rejection code was applied for each rejected task
Identify rejection code errors where the underlying enrollment, order, or claim remains actionable and can still be captured — distinguishing miscoded rejections from true terminal rejections
Surface identified rejection code errors directly to the Director of Patient Advocacy with sufficient detail for Managers to take immediate corrective action
Prioritize findings with active recovery potential to minimize revenue leakage and enable advocates to re-engage eligible patients before program or prescription deadlines lapse
Track patterns in rejection code misuse over time to identify training gaps or systemic coding errors within the advocate team
Continuous Improvement Identification
Document and track quality findings to support identification of opportunities to improve patient advocacy workflows, tools, 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
Requirements:
Education & Experience.
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
Technical Skills
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
Soft Skills & Attributes
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
About the company:
Atlas Health is dedicated to helping patients navigate the complexities of the healthcare system with ease and confidence. Our mission is to connect individuals with the financial assistance programs and resources they need to access essential medical care. By combining compassionate support with efficient processes, we ensure that patients receive the medications and services they require without unnecessary stress.
Our team works closely with healthcare providers, pharmacies, and financial aid programs to streamline assistance and improve patient outcomes. With a commitment to excellence and patient advocacy, we strive to make healthcare more accessible for everyone.
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