The Reorder Specialist is an integral member of the reimbursement team and has primary responsibility for the timely initiation and obtainment of a new medical order from the patient’s physician. The representative will also be in contact with physician offices for additional clinical information, progress notes and additional testing if required.
Essential Duties and Responsibilities:
- Obtains necessary documentation as dictated by payer, including clinical information not already on file (medical order, clinical notes, etc.), updated or continued usage documentation and medical criteria eligibility.
- Contacts the client, physician office and sales representative to relay or obtain pertinent information and documentation to ensure continued coverage.
- Completes weekly follow up with physicians to obtain extension orders signed for existing patients. Interacts with sales staff as needed to obtain required documentation.
- Responsible for generation of all reorder requests based on initial expiration.
- Compiles submitted documentation to accompany claim submission.
- Review submitted medical orders for completeness and accuracy according to payer standards.
- Performs other duties as assigned by Management.
Supervisory Responsibilities: None.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.
Educations and/or Experience:
- H.S. Diploma or equivalent required. Superior communication and customer service skills, and ability to handle multiple tasks simultaneously under strict deadlines.
- H.S. Diploma or equivalent required.
- 3-5 years experience in medical insurance verification.
- Strong negotiation skills.
- Experience working with all payer types to include Medicare, Medicaid and third party commercial insurance companies.
- Superior communication, customer service skills and strong phone presence.
- Ability to handle multiple tasks simultaneously under strict deadlines.
- Proficiency in MS Excel, email programs and online data systems
Language Skills: Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems and make appropriate judgment calls to insure the correct outcome.
Computer Skills: To perform this job successfully, an individual should be proficient in Microsoft Office Suite.
- The 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 frequently required to sit, walk, talk and hear. Employee may occasionally be required to lift and carry up to 25 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.