SME, Verification of Benefits

Abbott • Lake Mary, FL

12h • $21 - $42

About The Position

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Job Title SME, Verification of Benefits Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution. Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity This position works out of our Orlando, Florida location in the Abbott Heart Failure, Acelis Connected Health business. Our Heart Failure solutions are helping address some of the World’s greatest healthcare challenges. As the SME Verification of Benefits, you’ll have the chance to assist our patients in having accurate insurance information on file and collecting authorizations or PCP referrals as needed. What You’ll Work On The following reflects management’s definition of essential functions for this job, but does not restrict the tasks that may be assigned. Management may assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.

Requirements

• High School diploma or GED required
• Two or more years’ experience in VAD insurance benefits verification and prior authorizations
• Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
• Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices
• Understand the process for verification of benefits as it relates to the policies and procedures for effective placement of medical services.
• Complete Understanding of Medicare Rules and Regulations
• Understanding of Managed Care as it relates to benefits and authorizations
• Advanced MS Office experience, with an emphasis on MS Excel desired
• Continued Self Improvement courses & seminars related to position along with “In House” programs provided by Acelis Connected Health/Abbott.

Nice To Haves

• Associate’s Degree preferred
• Knowledge in Contracting and Fee Schedules
• Strong Computer/Software Skills

Responsibilities

• Contacts insurance companies to verify status of customer benefits.
• Files pre-authorizations for new and ongoing services with insurance companies and follow up for an outcome.
• Files Appeals to insurance companies as needed
• Gathers all necessary documents as requested by insurance companies.
• Maintains customer records in practice management system related to coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company.
• Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care.
• Provides customers with information regarding their status, which may include: developing financial breakdowns for the patient, giving the patient estimates of costs and collecting co-pays, if applicable.
• Assist in coordination of Single Case Agreements for non-contracted plans
• Applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes.
• Assist employees in understanding tasks and department processes and workflow
• Organize and distribute daily tasks as needed
• Provides feedback to management regarding department tools , workflow and payer outcomes that impact department processes and handling
• Work with Quality and Process team on department tools and work instructions
• Assists with employee on boarding and ongoing training
• Assists or leads department projects
• Point of contact to assist other departments on escalated issues or reported incidents or raise to management
• Performs other related duties as assigned.

Benefits

• Career development with an international company where you can grow the career you dream of.
• Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year.
• An excellent retirement savings plan with a high employer contribution.
• Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
• A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.
• Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: www.abbottbenefits.com

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees