Cardiac Diagnostics Reimbursement Specialist

The 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 Cardiac Diagnostic Reimbursement 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 Home Sleep Test and Heart Failure Management System.

This position is FULLY REMOTE

Duties and responsibilities

• Verification of benefits

• Obtain authorizations as required by payer

• Obtain necessary documentation (medical order, clinical notes, testing) and submit to insurance carrier for coverage determination when required by plan

• Conduct timely follow up on outstanding requests for new or corrected documentation, which may include contacting physician offices, hospitals and patients

• Maintain a score of at least Meets Expectations on monthly scorecard

• Identify qualifying diagnosis based on payer requirements

• Identify and facilitate timely completion of change of benefits as needed

• Contact customers, and physician offices to relay and/or obtain insurance information and/or additional documentation to assist with seeking reimbursement and coordination of benefits

• Completes Intake Order process and/or task follow as required by business need

• Performs other duties as assigned by management

Qualifications

Qualifications include:

• H.S. Diploma or equivalent required.

• Associate's or Bachelor's degree in nursing, business, or other related field preferred

• 2+ years insurance verification experience preferred

• 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

Working conditions

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.

Physical requirements

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 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 responsibility

None

AAP/EEO Statement

ZOLL 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

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The hourly pay rate for this position is:

Factors which may affect this rate include shift, geography, skills, education, experience, and other qualifications of the successful candidate. Details of ZOLL's comprehensive benefits plans can be found at www.zollbenefits.com.

Applications will be accepted on an ongoing basis until this position is filled. For fully remote positions, compensation will comply with all applicable federal, state, and local wage laws, including minimum wage requirements, based on the employee's primary work location.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or status as a protected veteran.

ADA: The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.