[Hiring] Cardiac Diagnostic Reimbursement Specialist @ZOLL Medical Corporation

Role Description

The Intake 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.

• Work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest.
• Create and maintain relationships with insurance companies, sales reps, and other internal departments.

Essential Functions

• Creation of patient record
• Verification of benefits
• Triage, work and resolve intake orders
• Explain medical need and educate insurance case managers on LifeVest system to obtain authorization for services
• Obtain necessary documentation (medical order, clinical notes, testing) and submit to insurance carrier for coverage determination
• Obtain authorizations as required by payer
• Execute timely follow up on all assigned tasks
• Maintain a score of at least Meets Expectations on monthly scorecard
• Identify qualifying diagnosis based on payer requirements
• Triage fax documents for timely review
• Communicate authorization results and order status to sales representatives
• Complete fee calculator and inform billing department of appropriate charges
• Contact 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

Qualifications

• High School Diploma required
• Associate's Degree or Bachelor's Degree in nursing, business, or other related field preferred
• Minimum of 2 years insurance verification experience required OR internal candidates with a minimum of 1 year experience supporting medical providers or patients in a phone queue

Knowledge, Skills and Abilities

• 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

Physical Demands

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Talking - Occasionally
• Hearing - Occasionally
• Repetitive Motions - Frequently

Compensation

The hourly pay rate for this position is: $19.00 to $23.00. Factors which may affect this rate include shift, geography, skills, education, experience, and other qualifications of the successful candidate.

Application Process

Applications will be accepted on an ongoing basis until this position is filled. For fully remote positions, compensation will comply with all applicable federal, state, and local wage laws, including minimum wage requirements, based on the employee’s primary work location.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or status as a protected veteran.

ADA Compliance

The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.