Reference #: R9340
CMSThe 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.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 managementQualifications
Qualifications include:
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 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 deadlinesAttention to detail
Superior organizational and time management skills
Ability to communicate policy information in a clear and detailed manner
Proficiency with MS Office SuiteWorking conditionsThe 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 requirementsThe 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 performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.Supervisory r sponsibility
NoneAAP/EEO StatementZOLL is committed to fostering an inclusive workplace, where unique identities, backgrounds, cultures, perspectives and experiences are respected and valued.Equal Opportunity Employer - Disability and VeteranAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.ZOLL LifeVest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, status as a qualified individual with a disability, or any other protected class status.