Insurance Pre-Authorization Specialist
Job no: 610017
Work type: Permanent
Location: Centennial, Colorado
Categories: Reimbursement, North America, Individual Contributor
Job Title: Insurance Pre-Authorization Specialist
Change people’s lives and love what you do! Cochlear develops world-leading medical devices that help people hear. As a 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 support cochlear implant clinics and recipients, we are recruiting for an Insurance Pre-Authorization Specialist. To be successful in this role, you will facilitate all pre-claim activity for reimbursement orders while providing exceptional service to internal and external customers. You will act with a sense of urgency to address inquiries while demonstrating a high degree of knowledge, integrity, and empathy in all aspects of team performance and operations.
As a subject matter expert in respective region and insurance plans, you will identify solutions while maintaining positive relationships with customers. You’ll work collaboratively with Billing & Collections, Customer Experience and other operations teams to provide the most efficient order process for our recipients.
- Location: Centennial, CO at our Americas Head Office
- Comprehensive training classes are approximately 3 weeks long which include classroom and hands-on instruction.
- Schedule: This full-time position requires flexibility to work an eight hour shift between 7:00am-6:00pm, Monday through Friday. In order to best serve our customers, occasional overtime may be required.
- Obtain the necessary documentation needed to progress orders taken by the reimbursement operations team and obtain insurance authorization on equipment ordered.
- Review and evaluate all documentation (Letter of Medical Necessity, Certificate of Medical Necessity, Assignment of Benefits, Insurance Intake Forms, etc.) for accuracy and effectiveness.
- Ability to perform Coordination of Benefits, including in depth understanding of In/Out of Network Benefits and how they relate to co-insurance and deductibles due and communicating out of pocket cost estimates to recipients
- Ability to appeal denied insurance prior authorization requests for equipment and services
- Provide data based on payor trends related to authorization, in-network exceptions, and one-time agreements.
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:
- High School Diploma or equivalent
- 2-3+ years of experience working with health insurance including but not limited to insurance verification, prior authorization, coordination of benefits and out of pocket cost estimate calculations
- Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier, and email)
- Must be able to work independently, possess strong organizational skills, successfully multi-task, and prioritize appropriately
- Excellent verbal and written communications skills
- Excellent customer service and phone skills with both internal and external customers
- Ability to work in a fast-paced environment and balance / manage multiple, changing priorities
- Must be detail-oriented and able to meet deadlines
- Bachelor’s degree
- Knowledge of Oracle and Brightree
- Experience with Durable Medical Equipment (DME) reimbursement
- Commercial, Medicare, and/or Medicaid insurance experience
Apply now by completing your application form online. 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. We have provided more than 550,000 implantable devices, helping people of all ages to hear and connect with life’s opportunities.
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 303-264-2340.
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