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.
To perform this job successfully an individual must be able to perform each essential duty proficiently. The requirements listed below are the knowledge, skills and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.
Essential Duties and Responsibilities:
- Creation of patient record
- Verification of benefits
- Explaining medical need and educating insurance case managers on LifeVest system to obtain authorization for services
- Obtaining necessary documentation (medical order, clinical notes, testing) and submitting to insurance carrier for coverage determination
- Obtaining authorizations
- Identifying qualifying diagnosis
- Communicating authorization results and order status to sales representatives
- Negotiating favorable rates with insurance companies with guarantee of assignment of benefits
- Completing fee calculator and informing billing department of appropriate charges
- Contacting 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 management
Educations and/or Experience:
- 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 deadlines
- Attention to detail
- Superior organizational and time management skills
- Ability to communicate policy information in a clear and detailed manner
- Proficiency with MS Office Suite
- Ability to read typed and handwritten correspondence
- Ability to write clear, concise correspondence
- Ability to effectively verbally present information in one-on-one and small group settings
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to compute rate, ratio, and percent
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
- Ability to deal with problems involving several concrete variables in standardized situations
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Ability to sit; use hands to finger, handle, or feel and talk or hear
- The employee is occasionally required to walk
- The employee must occasionally lift and/or move up to 10 pounds
The 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
ZOLL is an Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.