Intake Specialist-Fully-Remote, Various Shifts

CMS The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies. Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives. ZOLL has been Pittsburgh's Manufacturer of the Year, one of Western PA's Healthiest Employers, and even one of Pittsburgh's Coolest Offices. But it's our unique opportunity to impact people's lives that makes ZOLL the ideal place to build your career. Job purpose 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. Individual will work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest. Individual is responsible for creating and maintaining relationships with insurance companies, sales reps, and other internal departments. Shifts: Mon-Fri 1pm-9:30pm & Wed-Sat 8am-6:30pm (4-10) both fully remote. Duties and responsibilities 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 Performs other duties as assigned by management Qualifications H.S. Diploma or equivalent required. Associate's or Bachelor's degree in nursing, business, or other related field preferred 2-3 years insurance verification and authorization experience 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 Working conditions The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet. Physical requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While perfor

Created: 2024-10-19