Reference #: R5363
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 purposeThe 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 (Remote)Duties and responsibilitiesCreation of patient recordVerification of benefitsTriage, work and resolve intake ordersExplain medical need and educate insurance case managers on LifeVest system to obtain authorization for servicesObtain necessary documentation (medical order, clinical notes, testing) and submit to insurance carrier for coverage determinationObtain authorizations as required by payerExecute timely follow up on all assigned tasksMaintain a score of at least Meets Expectations on monthly scorecardIdentify qualifying diagnosis based on payer requirementsTriage fax documents for timely reviewCommunicate authorization results and order status to sales representativesComplete fee calculator and inform billing department of appropriate chargesContact 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 benefitsPerforms other duties as assigned by managementQualificationsH.S. Diploma or equivalent required. Associate's or Bachelor's degree in nursing, business, or other related field preferred2-3 years insurance verification and authorization experienceSuperior communication; both verbal and writtenStrong customer service skillsProficiency in navigating several software systems concurrentlyAptitude to handle multiple tasks simultaneously under strict deadlinesAttention to detailSuperior organizational and time management skillsAbility to communicate policy information in a clear and detailed mannerProficiency 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. T e employee must occasionally lift and/or move up to 25 pounds.Supervisory responsibility
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 Veteran#LI-SG1All 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.