Reimbursement Specialist

Reimbursement Specialist

Requirements

• High School Diploma required
• 3+ years’ experience in medical insurance verification preferred
• Experience working with all payer types to include Medicare, Medicaid and third-party commercial insurance companies preferred

Responsibilities

• Communicates medical need and educates case manager on LifeVest system to obtain authorization for services. Works with insurance carriers to authorize service for new and existing patients.
• Obtains necessary documentation for continued authorization as dictated by payer, including updated clinical information or forms.
• Contacts the client, physician office and sales representative to relay or obtain pertinent information and documentation to ensure continued coverage.
• Completes weekly follow up with insurance companies, physicians or sales team to obtain updated clinical and/or authorization decisions for new and existing patients.
• Interacts with sales staff as needed to obtain required documentation.
• Responsible for generation of all authorization requests.
• Performs other duties as assigned by Management.

Preferred Qualifications

• Superior communication and customer service skills, and ability to handle multiple tasks simultaneously under strict deadlines.
• Strong negotiation skills.
• Superior communication, customer service skills and strong phone presence.
• Ability to handle multiple tasks simultaneously under strict deadlines.
• Proficiency in MS Excel, MS Teams, email programs and Online data systems.