Job Title: Reimbursement Accreditation Program Analyst
Change people’s lives and love what you do! Cochlear develops world-leading medical devices that help people hear. As the top 100 medical device company and market-leader in implantable hearing devices, more people choose a Cochlear-branded cochlear implant system than any other. Our employees tell us that the number one reason they enjoy working for Cochlear is the opportunity to make a difference to people’s lives.
About the role
In order to help Cochlear improve operational efficiency, we are recruiting for a Reimbursement Accreditation Program Analyst in our Americas head office based in Centennial.
To be successful in this role you’ll be able to evaluate, interpret, and summarize accreditation guidelines and to manage the process for accreditation activities. You’ll work collaboratively with Reimbursement Operations, Billing & Collections, Customer Experience, and warehouse, etc. to ensure alignment to DMEPOS Accreditation and Supplier Standards. This analyst role is responsible for focusing on ensuring best practices are being followed and that Cochlear is continuously focusing on performance and quality improvement.
In this role you'll have the opportunity to make a significant contribution to Cochlear's successful history of innovation by applying your knowledge of Reimbursement and Accreditation Standards. You'll know you've been successful in this role when you've helped Cochlear Americas maintain ACHC Accreditation.
- Understand, support, and analyze the company’s ongoing compliance with DMEPOS accreditation and supplier standards
- Assist in the implementation and maintenance of Cochlear’s quality improvement program
- Support and prepare for accreditation surveys conducted by authorized inspection agencies
- Identify compliance gaps within the company and work with appropriate business partners to correct and/or mitigate potential issues
- Analyze data and facts to identify Cochlear’s areas of strength and any needing improvement
- Reviews state and federal laws, rules and regulations, and accreditation standards to keep the company apprised of new published developments
- Maintain all accreditation related policies and procedures to include the tracking and management of those policies in Cochlear’s documentation and management system
- Assist department leaders and team members with ensuring accreditation standards are understood and are meeting compliance requirements
- Perform mock audits and surveys to ensure quality standards are continuously monitored
- Perform quarterly read outs and present audit findings to Cochlear’s compliance officer
- Serve as the point of contact for external accreditation and CMS auditors
To add value to Cochlear in this role you'll be able to demonstrate the following skills and experience in your application and at interview:
- Bachelor’s Degree or 3+ years’ work experience in the health insurance field, including pre-authorization of benefits, appeals, billing and coding
- Extensive knowledge of government insurance (Medicare, Medicaid)
- Extensive knowledge of commercial insurance plans and benefits (PPO, HMO, POS, EPO, Indemnity)
- Commitment to exceptional services
- Extremely organized with a strong attention to detail
- Understanding of DME operations and billing
- Understanding of Coordination of Benefits (COB)
- Strong, applicable knowledge of MS Office Programs including Word, Excel, and PowerPoint
- Must exhibit a sense of urgency, high level problem solving abilities, and excellent written and verbal communication skills
- Ability to work in a changing environment under strict deadlines without supervision or exception
- Ability to indirectly influence others, drive change and respond/manage feedback
- Demonstrates time management skills. Has the ability to prioritize current workload and projects and provides periodic updates to management on status
- Familiar with HIPAA and accreditation standards
- Durable Medical Equipment (DME) background
- Prior experience in call center operations, email / fax order management / supply chain
- Understanding of Medicare / Medicaid provider manuals
- Familiar with the accreditation survey process and expectations
Apply now by completing your application form online. Cochlear is an equal employment opportunity organization. Applicants must meet the job specific application criteria to be considered.
Working at Cochlear Americas:
- Work with dedicated and passionate colleagues to help more people hear
- Highly collaborative global team environment
- Opportunities for growth and development
- Competitive salary and bonus
- Comprehensive benefits including medical, dental, vision, life insurance, retirement plans, paid holidays/vacation, tuition reimbursement, and extended Paternity Leave.
- State of the art facility with great work/life balance conveniences (onsite gym, wellness programs, dry cleaning services, company-sponsored monthly food truck and more!)
Cochlear pioneered and is the global leader in the research and development, manufacture and marketing of implantable hearing solutions. Cochlear’s global headquarters is located in Sydney, Australia where we design and manufacture the leading cochlear implant devices in the world. A success story in the commercialization of R&D, Cochlear has more than 60% share of the global market, employs more than 3,500 people worldwide, operates directly in over 20 countries and sells in over 100 countries. Over 550,000 people across more than 100 countries now experience hearing as a recipient of a Cochlear hearing solution.
As a world-leader in innovative medical devices, Cochlear encourages continuous learning for employees. Visit www.cochlear.com/careers for more information.
Cochlear Americas is an Equal Opportunity, Affirmative Action Employer and provides equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, marital status, veteran status, or any other characteristic protected by federal, state or local law. In addition, Cochlear will provide reasonable accommodations for qualified individuals with disabilities. If you require accommodation with completing the online application, please contact us via web or phone at 303-264-2349.