Prior Authorization Specialist

Cochlear • Lone Tree, CO

1d • $24 - $26 • Hybrid

About The Position

Change people’s lives and love what you do! Cochlear is helping people hear, and be heard, all over the world and is the most recognized brand in hearing health care. About the role If you have a passion for working with health insurance providers and are looking for an opportunity to develop your knowledge and grow professionally, this is a fantastic opportunity to join the Reimbursement Operations team at the global leader in implantable hearing devices! In this role, you will be based in our Americas head office based in Lone Tree, CO. This role requires full in-person attendance during the initial training period and transitions to a hybrid work model based on performance, as assessed by your supervisor. OR In this role, you will be based in our Americas head office based in Lone Tree, CO. This role is hybrid, requiring you to be in the office 2 days per week minimum, with 3 days per week working from home. OR: This role offers a hybrid or remote work environment dependent on place of residence. For Denver-metro based candidates, this role requires full in-person attendance during the initial training period and transitions to a hybrid work model based on performance, as assessed by your supervisor. Remote eligible candidates will reside outside of the Denver-metro area and have an excessive commute to the Lone Tree office. Your success in this role is measured by your ability to facilitate all pre-claim activity for reimbursement orders while providing exceptional service to internal and external customers. Work collaboratively with your peers within a region setting where you will develop subject matter expertise, as well as with internal stakeholders in Billing and Collections, Customer Experience and other operations teams to provide the most efficient order process for our recipients.

Requirements

• Bachelors or Equivalent Work Experience
• 2-3 years of experience ideally working with health insurance, including but not limited to:
• Insurance Verification
• Prior Authorization
• Coordination of Benefits
• Out of Pocket cost estimate calculations
• Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships
• Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier and email).
• Excellent verbal and written communication skills

Responsibilities

• Verify eligibility, investigate insurance benefits and validate coverage; calculate and collect recipient out of pocket estimates based on their deductible, coinsurance and out of pocket maximum
• Navigate and utilize operational resources while managing orders following date and urgency prioritization workflow
• Collect documentation based on payor requirements and medical professional preferred method
• Evaluate medical documentation for accuracy, requirements and validity and submit to insurance for prior authorization when required
• Communicate professionally, effectively and clearly with customers to ensure understanding and meet the customer need; engage with cross functional business partners to support reimbursement processes, orders and customers
• Secure in network exceptions and negotiate one-time agreements with insurance payors in which Cochlear is non-participating

Benefits

• Benefit package includes medical, dental, vision, life and disability insurance as well as 401(K) matching with immediate vesting, Paid Time Off, tuition reimbursement, maternity and paternity leave, Employee Stock Purchase Plan and pet insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level