Provider Benefit Verification Specialist

Largo, FL

Job Req code: 940

Category: Other

We have unique opportunities and are always looking for exceptional talent. Join a company where you will have an opportunity to grow professionally and personally and give strength to others by Empowering Healing.  The Provider Verification Specialist position provides support for  billing and reimbursement to sales specialists and customers.

KEY RESPONSIBILITIES

  • Investigate patient’s medical benefits and identify opportunities for prior authorizations.
  • Prepare and submit prior authorizations in a timely manner.
  • Effectively interface with hospitals, wound care centers and physicians to insure the highest level of reimbursement is attained.
  • Communicate and accurately document payor trends.
  • Foster partnerships with national accounts.
  • Monitor and update Medicare, Medicaid and Private Payor policies and guidelines.
  • Monitor and communicate policy developments that impact the reimbursement success of products.
  • Help build relationships in key markets with government, physician, hospital, and third-party payer decision makers.
  • Oral presentation skills preferred to give quarterly meetings.
  • Other duties as needed.

Requirements

  • BA/BS degree in Health care Administration, Business, Economics preferred or equivalent work experience. 
  • Three plus years of work experience in the health care industry.
  • Medical device or biologics experience preferred.
  • Functional expertise in reimbursement and health care policy is necessary.
  • Must possess an intimate knowledge of Medicare, Medicaid, Managed Care and Private Payor reimbursement process.

 

Physical Activities

  • Remaining in a sitting position for long periods of time.
  • Repeating motions that may include the wrists, hands, and/or fingers.

 

Environmental Conditions

  • Working indoors
  • No adverse environmental conditions