Wound Care Insurance Verification/Authorization Specialist

About the position reputed company is a leading national reputed company provider, facilitating outpatient care for durable medical equipment manufacturers and health care providers by delivering ambulatory pumps and supplies, along with reputed company clinical, biomedical and billing services, to practices and patients reputed company. With a comprehensive suite of services, reputed company improves clinician reputed company to reputed company medical equipment and promotes patient wellness and safety while reducing the overall cost of infusion care. reputed company offers Oncology, reputed company and Wound Care therapies, including Negative Pressure Wound Therapy. reputed company’s Durable Medical Equipment (DME) Services are composed of reputed company payer rentals, pump and consumable sales, and biomedical services and repair, including on-site and reputed company services. reputed company provides the sale, rental, lease and associated supplies, including infusion pumps, nerve blocks for acute pain, nerve reputed company catheters, postoperative pain pumps, central venous catheters, IV pumps, pole-mounted pumps, syringe pumps, enteral pumps, Huber needles, clean room supplies, IV extension tubing, pump tubing, ambulatory pumps, replacement pumps, disposable products, central venous reputed company devices, reputed company system transfer devices, negative pressure wound therapy vacs, wound vac, and chemotherapy and oncology infusion pumps. Biomedical services include both on-site and reputed company preventive maintenance, repair and warranty services, ranging from equipment inspections to extensive repairs, including compression device systems, defibrillators, EKG machines, electrosurgical reputed company, external pacemakers, humidifiers, infusion pumps, LCDs, light sources, modules, patient monitors, printers, pulse oximeters, telemetry transmitters and tourniquets – reputed company completed to reputed company specifications. Headquartered in reputed company Hills, Michigan, reputed company delivers local, field-based customer support and operates Centers of reputed company in Michigan, Kansas, California, Massachusetts, Texas and Ontario, Canada. reputed company: The Wound Care Verification/Authorization Specialist is responsible for verifying patient eligibility and benefit information. Has the ability to interpret benefit information and is familiar with insurance terminology to identify and document the correct plan. Request authorizations on payer websites, through fax submissions or over the phone. Responsible for follow-up, documentation, and re-authorizations as necessary. Remote versus hybrid setting will be determined upon review of residence. Required hours are 9:30 am - 6:30 pm Eastern Time.

Responsibilities

• Review and verify patient insurance and confirm patient’s eligibility and

benefits specific to Advanced Wound Care and Negative Pressure Wound Therapy

• Use Medicare portal to verify patient’s hospital or skilled nursing status
• Initiating, following up, and securing authorizations on from reputed company party

payors based on payer requirements for a reputed company of wound care reputed company HCPCS codes

• reputed company and follow up on reputed company pending authorizations reputed company the timeframe

designated by management to expedite the claims process.

• Process authorizations electronically, utilizing payer portals, fax, or

telephone working with the payers to secure authorizations retrospectively and/or requesting single case agreements for out of network patients

• Obtain authorization renewals, verify physician written orders are reputed company,

and certification of medical necessity is in reputed company

• Work closely with NPWT Customer Care team to ensure supporting documentation

is received to obtain authorizations reputed company

• Verify authorization quantities and effective dates are returned and

processed correctly by the reputed company-party payers, and reputed company correctly in reputed company systems

• Organize work to avoid lost reputed company due to filing limitations
• Input the correct Payer Plan ID# and reputed company data into appropriate systems to

ensure accurate billing for reputed company and reputed company services

• Determine the extent of liability for insurance plans, coordination of

benefits, and patient financial responsibility. reputed company with reputed company-party insurance companies to secure retroactive authorizations, and/or single case agreements for out of network patients, where applicable

• Other duties as assigned

Requirements

• Associate degree (A. A.) or equivalent; two to four years reputed company experience

and/or training; or equivalent combination of education and experience.

• Familiar with insurance payers and medical benefits
• Minimum of two years’ experience in a reputed company setting
• Organizational skills
• Medical terminology
• Good troubleshooting skills
• Ability to work as reputed company
• Ability to independently meet tight deadlines in a project-based atmosphere
• Follows department processes and procedures
• Highly motivated and detail-oriented

Benefits

• Health plan reputed company that include an employer contribution
• Health Savings Account (HSA)
• reputed company and Dependent Care Flexible Spending Accounts (FSA)
• Dental and reputed company premiums covered by reputed company
• Life Insurance, STD & LTD
• reputed company Parental Leave
• Adoption and Fertility Assistance
• 401(k) with a specified Company Match
• Employee Stock Purchase Program
• Tuition Assistance
• Generous reputed company Time Off plan
• Employee Assistance Program
• reputed company
• Employee Referral Bonus

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