Billerica, Massachusetts
Reimbursement Specialist Job Opening in Billerica, Massachusetts - This position is responsible for reimbursement processing for Insulet products. This role is an essential part of the customer management process and will work directly with other team members and departments to ensure that there is strong communication between Insulet, physicians, insurance providers and OmniPod customers.
The Reimbursement Specialist is able to independently follow standardized workflows as defined by management. This is a skilled position that requires customer service and/or healthcare reimbursement experience and the ability to apply acquired skills to ensure the insurance claim is processed correctly and the company is able to successfully collect. The Reimbursement Specialist will be expected to work on a broad range of tasks including some more complex situations.
Responsibilities:
Understand Insulet insurance contracts, channeling and processing requirements for all covered products.
Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.
Submission of all prior authorization requests for approval and payment of Insulet products at time of claim processing.
Calculate and document cost share amounts for potential customers.
Collaborate with other commercial teams such as Case Management, OmniPod Sales and Billing, to ensure proactive communication of potential customer?s order status.
Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.
Provide frequent feedback and suggestions to support an environment of continuous process improvement.
Performs other duties as assigned.
Education and Experience
2-3 years? related experience in a professional working environment, preferably with extensive phone coverage and medical device or health care oriented.
Individual health plan insurance knowledge and understanding of the managed care industry is required.
Bachelor's Degree or equivalent experience is required.
Knowledge of diabetes and experience supporting patients with diabetes is preferred.
Experience with Salesforce CRM (preferred).
Skills/Competencies:
Oral Communication - The ability to express oneself clearly in conversations and interactions with others.
Written Communication - The ability to express oneself clearly in business writing.
Fostering Teamwork - The ability and desire to work cooperatively with others on a team.
Thoroughness - Ensuring that one's own and others' work and information are complete and accurate; following up with others to ensure that agreements and commitments have been fulfilled.
Stress Management - The ability to function effectively in a fast-paced environment, while under pressure. Maintains self-control in the face of hostility or provocation. Can handle several problems or tasks at once through effective time management and multi-tasking. Ability to identify and escalate issues requiring management support.
Technical Expertise - Demonstrating depth of knowledge and skill using standard business / office technology and applications.
Other Important Skills / Competencies ? Flexibility, Diagnostic Information Gathering, Analytical Thinking, Initiative, Self Confidence and Customer Orientation.
Physical Requirements:
Requires sitting and standing associated with a normal office environment.
Manual dexterity needed for using a calculator and computer keyboard.
Lightweight lifting may be required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job Type: Full-time
Salary: $19.00 to $21.00 /hour
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