Change of Benefits Specialist
About The Position
At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions. ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed to deliver better insights and better outcomes. On any given day, clinicians utilize these ZOLL products for tens of thousands of cardiac patients around the world: LifeVest, the world's first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death. HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent. TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20+ years ago to reduce infarct size in patients with the most severe heart attacks. 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. 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. Job Summary The Change of Benefits Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of accounts with a change to insurance coverage. This individual will work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest. Individual is responsible for creating and maintaining relationships with insurance companies, sales team, and other internal departments.
Requirements
- High School Diploma or equivalent required and Associate's Degree in nursing, business, or other related field preferred or Bachelor's Degree in nursing, business, or other related field preferred
- 2-3 years insurance verification experience 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
Responsibilities
- Verification of benefits
- Explaining medical need and educating insurance case managers on LifeVest system to obtain authorization for services
- Obtaining necessary documentation (forms, clinical notes, testing) and submitting to insurance carrier for coverage determination
- Obtaining authorizations from insurance companies
- Communicating authorization requirements and results to sales representatives
- Negotiating favorable rates with insurance companies with guarantee of assignment of benefits
- Completing fee calculator and informing billing department of appropriate charges
- Contacting customers, physician offices, and sales representatives to relay and/or obtain insurance information and/or additional documentation to assist with seeking reimbursement and coordination of benefits
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
Number of Employees
1,001-5,000 employees
