Reimbursement Case Specialist
Responsibilities Verify current insurance coverage policies and benefits specifics through direct contact with medical insurance providers and ensure prompt return of accurate information to healthcare professionals to facilitate ongoing patient care with Integra products Assist with the coordination of the case set up with wound care center/ providers, patients and sales representative Develop productive working relationships with internal and external field sales representatives to provide coordinated support to healthcare providers and patients interested in treatment with Integra products Demonstrate proficiency and full understanding of the Reimbursement Services Center Customer Relationship database including understanding of data elements, definition of various case statuses and outcomes, case documentation requirements and the importance of meeting program metrics. Provide the highest level of customer service while acting as the single point of contact for healthcare providers to case manage all steps required to gain access to treatment with Integra's products Handle all protected patient data according to strict HIPAA compliance and ethical record-keeping Accurately document call details, follow up actions, and any other pertinent information within the Customer Relationship Management database Identify and escalate customer concerns and program trends to the Reimbursement Services Manager as well as Reimbursement Services Center team
Qualifications Education:
Minimum Associates degree or equivalent; Bachelor's degree from an accredited college, university or equivalent preferred. Certifications:
None
Experience:
Minimum of 5 years working directly with various medical insurance companies Reimbursement case management experience, or experience working in a reimbursement services center preferred Understanding of medical insurance benefit response Experience verifying patient benefits, eligibility and authorization requirements via phone call directly to the insurance Experience working in a high-volume patient services program preferred Extensive knowledge of health plan reimbursement Understanding of ICD-10 diagnosis codes and HCPCS codes Prior reimbursement experience with ability to communicate complex reimbursement scenarios and solutions to patients and medical professionals. Demonstrated ability to work collaboratively in a team environment and as an independent contributor Ability to think critically and problem solve to address customer needs and barriers to product fulfillment
Salary Range:
$80K -- $100K
Minimum Qualification
NursingEstimated Salary: $20 to $28 per hour based on qualifications.
Qualifications Education:
Minimum Associates degree or equivalent; Bachelor's degree from an accredited college, university or equivalent preferred. Certifications:
None
Experience:
Minimum of 5 years working directly with various medical insurance companies Reimbursement case management experience, or experience working in a reimbursement services center preferred Understanding of medical insurance benefit response Experience verifying patient benefits, eligibility and authorization requirements via phone call directly to the insurance Experience working in a high-volume patient services program preferred Extensive knowledge of health plan reimbursement Understanding of ICD-10 diagnosis codes and HCPCS codes Prior reimbursement experience with ability to communicate complex reimbursement scenarios and solutions to patients and medical professionals. Demonstrated ability to work collaboratively in a team environment and as an independent contributor Ability to think critically and problem solve to address customer needs and barriers to product fulfillment
Salary Range:
$80K -- $100K
Minimum Qualification
NursingEstimated Salary: $20 to $28 per hour based on qualifications.
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