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Prior Authorization Specialist - May 15, 2023 Start Date (Remote Eligible)
Company | Cochlear |
Address | Oregon, United States |
Employment type | FULL_TIME |
Salary | |
Category | Medical Equipment Manufacturing |
Expires | 2023-05-12 |
Posted at | 1 year ago |
Reimbursement Operations PreClaim Specialist (Prior Authorization Specialist)
- 3-week comprehensive training experience
- Hybrid or remote work environment dependent on place of residence
- Flexibility to work 8 hours within region-specific schedule
- Execute all pre-claim activity for reimbursement orders
- Communicate professionally, effectively and clearly with customers to ensure understanding and meet the customer need
- Secure in‐network exceptions and negotiate one-time agreements with insurance payors in which Cochlear is nonparticipating
- Verify eligibility, investigate insurance benefits and validate coverage; calculate and collect recipient out‐of‐pocket estimates based on their deductible, coinsurance and out‐of‐pocket maximum
- Evaluate medical documentation for accuracy, requirements and validity and submit to insurance for prior authorization when required
- Manage first‐level appeals in response to prior authorization denials
- Engage with cross‐functional business partners to support reimbursement processes, orders and customers
- Collect documentation based on payor requirements and medical professional preferred method
- Out of Pocket cost estimate calculations
- Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships
- Excellent verbal and written communication skills
- Insurance Verification
- Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier and email).
- Prior Authorization
- 2-3 years of experience ideally working with health insurance, including but not limited to:
- Bachelors or Equivalent Work Experience
- Coordination of Benefits
- Target Salary Range/Rate: $21.50 – $22.12 per hour based upon experience, as well as an annual bonus opportunity of 5% of base salary. Compensation offered to candidate may vary based on work experience, education and/or skill level.
- Benefit package includes medical, dental, vision, life and disability insurance as well as 401(K) matching with immediate vesting, Paid Time Off, tuition reimbursement, maternity and paternity leave, Employee Stock Purchase Plan and pet insurance.
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