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Insurance Upgrade Specialist - United States
Posted on : 15 April 2017
|Advanced Bionics is a global leader in developing the most advanced cochlear implant systems in the world. Always focused on innovations that improve quality of life, AB has consistently made the industry’s leading advancements in hearing technology. In fact, with six sound coding programs, we offer more ways to hear than any other cochlear implant company. |
Our company is part of the Sonova Group, the leading provider of hearing healthcare solutions and parent company of Phonak, the leading hearing instrument brand.
As an AB employee, you will contribute to advancing biomedical technology worldwide and work on challenging projects with smart, driven, friendly people.
AB provides thriving work environments around the globe; each fosters creativity, teamwork, global competitiveness, and professional growth.
Experience the professional and personal fulfillment that comes with making a difference in people’s lives. Apply to Advanced Bionics today.
|Advanced Bionics / USA / Valencia (CA)|
|Insurance Upgrade Specialist|
| PRIMARY FUNCTION: |
Responsible for interfacing with patients, company sales and/or service representatives, ambulatory surgery and implant centers/facilities and insurance carriers to handle a variety of pre-sales and post-sales service functions in the area of insurance reimbursement: verifies benefits, prepares pre-authorization requests, documents approvals, and follow-up with appeals in response to insurance company denials. Obtains patient information and maintains database of patient files. Facilitates communication between insurers, clinics and patients, expediting exchange of required data and dealing with insurance problems. Exercises some independent judgment, works on assignments that are semi-routine in nature where ability to recognize deviation from accepted practice is required. Normally receives general instructions on routine work, detailed instructions on new assignments.
DUTIES & RESPONSIBILITIES:
1. Establish working relationship with centers’ billing staff. Answer telephone inquiries and obtains necessary information to set up patient charts and maintain files.
2. Refers patients to appropriate center for medical evaluation. Act as liaison, where necessary, to facilitate completion of evaluation.
3. Verify benefits, prepare and file pre-authorization requests and medical claims. Complete standard follow-through calls and monitor status of case until approved.
4. Maintain and update medical insurance database; understand full consequences for input into database.
5. Assist subordinates in preparing materials for presentation to clinics and insurers, e.g., appeals packages, updates for Insurance Guidebook, and related materials.
6. Coordinate with subordinates and supervisor with regard to complicated and problem cases and assist in appeals process.
7. Perform other related duties as assigned, including special projects.
EXPERIENCE: Experience in medical insurance required. Experience with medical device prior authorization preferred.
SPECIALIZED KNOWLEDGE & SKILLS:
1. Ability to communicate well with medical personnel, insurance representatives, customers and their families. Knowledge of the language of the medical profession. Be able to facilitate and educate, where necessary, between medical profession and customers.
2. Diplomacy, persistence, attention to detail in all facets of position. Sound administrative skills, to include written correspondence composition, and verbal communication skills in dealing with difficult situations.
| EDUCATION and TRAINING: High school diploma or equivalent required; college undergraduate degree preferred. |
PHYSICAL ENVIRONMENT / WORKING CONDITIONS: (i.e. assembly line, lifting requirements (up to ___ lbs), equipment used, etc.
RESPONSIBILITY FOR PERSONNEL: Indirect Supervision
|Advanced Bionics is committed to creating a diverse environment and is proud to be an affirmative action/ equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.|
|Advanced Bionics LLC |
28515 Westinghouse Place
Valencia, CA 91355
+1 661 362 4747