Reimbursement Specialist (Authorizations Department)– M-F 8:30am-5:00pm (Hybrid)

CMS

At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.

ZOLL Cardiac Management Solutions Offers a Unique Portfolio Of Novel Technologies Designed To Deliver Better Insights And Better Outcomes. On Any Given Day, Clinicians Utilize These ZOLL Products For Tens Of Thousands Of Cardiac Patients Around The World

• LifeVest, the world first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death.
• HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent.
• TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20 years ago to reduce infarct size in patients with the most severe heart attacks.
  
  

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.

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 Summary

The Reimbursement Specialist is an integral member of the reimbursement team and has

primary responsibility for the timely initiation of authorizations with insurance carriers for new

and established patients. The representative will also be in contact with the physician office and

sales staff for additional clinical information, progress notes and additional testing when required.

Essential Functions

• Communicates medical need and educates case manager on LifeVest system to obtain authorization for services.
• Works with insurance carriers to authorize service for new and existing patients.
• Obtains necessary documentation for continued authorization as dictated by payer, including updated clinical information or forms.
• 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 insurance companies, physicians or sales team to obtain updated clinical and/or authorization decisions for new and existing patients.
• Interacts with sales staff as needed to obtain required documentation.
• Responsible for generation of all authorization requests.
• Performs other duties as assigned by Management.
  
  

Required/Preferred Education And Experience

• High School Diploma required
• 4-6 years experience in medical insurance verification required
• 1-3 years experience working with all payer types to include Medicare, Medicaid and third-party commercial insurance companies required
  
  

Knowledge, Skills And Abilities

• Superior communication and customer service skills, and ability to handle multiple tasks simultaneously under strict deadlines.
• Strong negotiation skills.
• Superior communication, customer service skills and strong phone presence
• Ability to handle multiple tasks simultaneously under strict deadlines
• Proficiency in MS Excel, MS Teams, email programs and Online data systems.
  
  

Travel Requirements

• 10% Travel up to 10%
  
  

Physical Demands

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.

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Talking - Occasionally
• Hearing - Occasionally
• Repetitive Motions - Frequently
  
  

ZOLL is a fast-growing company that operates in more than 140 countries around the world. Our employees are inspired by a commitment to make a difference in patients's lives, and our culture values innovation, self-motivation and an entrepreneurial spirit. Join us in our efforts to improve outcomes for underserved patients suffering from critical cardiopulmonary conditions and help save more lives.

The Hourly Pay Rate For This Position Is

$19.50 to $22.50

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.