Cardiac Diagnostics Reimbursement Specialist

ZOLL Medical Corporation•Tampa, FL

2d•Remote

About The Position

The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest® wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies. Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives. ZOLL has been Pittsburgh’s Manufacturer of the Year, one of Western PA’s Healthiest Employers, and even one of Pittsburgh’s Coolest Offices. But it’s our unique opportunity to impact people’s lives that makes ZOLL the ideal place to build your career. The Cardiac Diagnostic Reimbursement Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of new medical orders from hospitals and physician offices. This individual is responsible for front-end functions of the order fulfillment process. Individual will work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for Home Sleep Test and Heart Failure Management System. This position is FULLY REMOTE

Requirements

H.S. Diploma or equivalent required.
Superior communication; both verbal and written
Strong customer service skills
Proficiency in navigating several software systems concurrently
Aptitude to handle multiple tasks simultaneously under strict deadlines
Attention to detail
Superior organizational and time management skills
Ability to communicate policy information in a clear and detailed manner
Proficiency with MS Office Suite

Nice To Haves

Associate’s or Bachelor’s degree in nursing, business, or other related field preferred
2+ years insurance verification experience preferred

Responsibilities

Verification of benefits
Obtain authorizations as required by payer
Obtain necessary documentation (medical order, clinical notes, testing) and submit to insurance carrier for coverage determination when required by plan
Conduct timely follow up on outstanding requests for new or corrected documentation, which may include contacting physician offices, hospitals and patients
Maintain a score of at least Meets Expectations on monthly scorecard
Identify qualifying diagnosis based on payer requirements
Identify and facilitate timely completion of change of benefits as needed
Contact customers, and physician offices to relay and/or obtain insurance information and/or additional documentation to assist with seeking reimbursement and coordination of benefits
Completes Intake Order process and/or task follow as required by business need
Performs other duties as assigned by management