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Reimbursement Specialist; M-F 8:30AM-5:00PM
Reimbursement Specialist; M-F 8:30AM-5:00PM-January 2024
Pittsburgh
Jan 8, 2025
About Reimbursement Specialist; M-F 8:30AM-5:00PM

  Reference #: R11837CMS

  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.

  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 Summary

  The Reimbursement Specialist is an integral member of the reimbursement team and hasprimary responsibility for the timely initiation of authorizations with insurance carriers for newand established patients. The representative will also be in contact with the physician office andsales staff for additional clinical information, progress notes and additional testing when required.

  Essential FunctionsCommunicates 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 ExperienceHigh School Diploma required4-6 years experience in medical insurance verification required and 1-3 years experience working with all payer types to include Medicare, Medicaid and third-partycommercial insurance companies required

  Knowledge, Skills and AbilitiesSuperior communication and customer service skills, andability to handle multiple tasks simultaneously under strict deadlines.Strong negotiation skills.Superior communication, customer service skills and strong phone presenceAbility to handle multiple tasks simultaneously under strict deadlinesProficiency in MS Excel, MS Teams, email programs and Online data systems.

  Travel Requirements10% 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 - OccasionallyWalking - OccasionallySitting - ConstantlyTalking - OccasionallyHearing - OccasionallyRepetitive 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' 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.

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

  ZOLL LifeVest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, status as a qualified individual with a disability, or any other protected class status.

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