Our client is seeking a Reimbursement Specialist who can independently follow standardized workflows as defined by management.
- Understand insurance contracts, channeling and processing requirements for all covered products.
- Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.
- Submission of all prior authorization requests for approval and payment of products at time of claim processing.
- Calculate and document cost share amounts for potential customers.
- Collaborate with other commercial teams.
- Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.
Education and Experience:
- Associates/Bachelor’s Degree and/or equivalent combination of education and experience.
- 2-3 years’ related experience in a professional working environment, preferably with extensive phone coverage and medical device or health care oriented.
- Individual health plan insurance knowledge and understanding of the managed care industry is required.
- Knowledge of diabetes and experience supporting patients with diabetes is preferred.
- Experience with Salesforce CRM (preferred).
Note: Qualified candidates will be contacted within 2 business days of application. If an applicant does not meet the above criteria, we will keep your resume on file for future opportunities and may contact you for further discussion.