Insurance Support Services Team Lead

MED-EL Corporation•Durham, NC

3d•Remote

About The Position

The Insurance Support Services (ISS) Team Lead is responsible for providing operational support, floating regional coverage, training assistance, and day-to-day guidance to the region’s supervisor and team members. This role ensures that internal and external stakeholders receive best-in-class service by upholding company standards and established processes. The ISS Team Lead also delivers exceptional customer support and serves as a point of contact for escalated phone calls, urgent issues, and complex customer needs.

Requirements

Familiarity with all medical coding systems (CPT, ICD-10, HCPCS).
Insurance coverage research experience and work with payers for product coverage.
Excellent communication skills (verbal, written, and in-person) and customer service skills for internal and external customers.
Ability to maintain concentration and attention to intricate details for extended periods while sitting at a desk.
Maintain current extensive knowledge of Medicare/Medicaid and private payer insurance programs as related to authorization of medical services, eligibility and insurance billing and collection related to company products.
Uphold MED-EL Quality System requirements, detailed operational procedures, and various regulatory requirements relevant for medical device companies, Medicare, and Medicaid Providers.
Perform under pressure, including time-pressure/deadlines, quality audits and various regulatory (FDA, HIPAA, Medicare, OIG, OCI) inspections, etc.
Medical preauthorization and appeals experience and familiarity.
Experience with hearing implant front-end VOBs, authorizations, denials, and appeals.
Demonstrated professional approach to continued service improvement – when opportunities are noticed, approach the opportunity collaboratively, engaging management as appropriate.
Demonstrated knowledge of coverage guidelines with major payers in assigned regions; and demonstrated ability to read and interpret coverage guidelines for payers when research is required, when providing floating coverage, and when coaching team members to higher levels of performance.
Ability to develop, evaluate, prioritize, and implement near-term and long-range goals and strategic initiatives to improve department efficiency and effectiveness for maximum company profit while optimizing patient and customer (clinic) positions.
Ability to directly interface professionally and courteously with patients, customers (clinics), and industry professionals in both private and group situations via dialogue or giving presentations by phone, email, or in person
High School graduate or equivalent.

Nice To Haves

Minimum 2-3 years MED-EL Insurance Support or Revenue Cycle experience preferred.
Local to Durham preferred. Open to remote candidates.

Responsibilities

Provide floating coverage within supported regions to meet daily staffing needs and during staff absences.
Manage assigned customers, centers, regions, as business needs evolve.
Support specialty product lines (e.g., HEAR4U) and/or assigned states/customer groups.
Process orders for Initial Implants for assigned states and customer groups.
Handle escalations and urgent orders in absence of the supervisor.
Provide backup support to peers (Team Leads) and supervisors when required.
Ensure all team activities comply with relevant regulations and standards, including HIPAA guidelines.
Conduct ongoing training reviews for existing staff, as determined and directed by the team’s supervisor, to ensure they remain up to date on the latest industry practices, regulations, and any updated or new processes.
Work closely with other departments, such as Customer Account Services and Revenue Cycle, to ensure seamless operations and effective communication.
Comply with and adhere to all regulatory compliance areas, policies, procedures and organizational "best practices."

Benefits

Medical, dental, and vision coverage available, effective on the first day of the month following 30 days of active service.
Health Savings Account
Short term and long-term disability paid by the company.
Company paid life insurance with an option to purchase additional coverage.
FSA Dependent Care
Pet Insurance
Critical Illness
Accident Insurance
PTO – 20 days annual that is accrued each pay period. Plus 40 hours Medical/Sick leave annual, prorated from hire date and 9 holidays.
Employee Assistance Program