Boston Scientific
Pre-Authorization Specialist II
Boston Scientific, Washington, District of Columbia, us, 20022
Pre-Authorization Specialist II
The Reimbursement Pre-Authorization Specialist II is responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department. Work Mode: Remote in country Onsite Location(s): United States Additional Location(s): N/A Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance At Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information, and training, we'll help you in advancing your skills and career. Here, you'll be supported in progressing whatever your ambitions. Day Shift - Flexible Hours Your responsibilities will include: Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service Create electronic folders for new patients Organize patient medical records in preparation for prior authorization and appeals process Answers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome Communicates and builds relationships with HCP offices and Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits etc. Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases Coordinates with lead and supervisor regarding complicated cases Required qualifications: High School Diploma Minimum 3-year Insurance Pre-Authorization Reimbursement experience Experience working with various payors including, Medicare, Medicaid and Private Payor, as it relates to medical procedures, services, and devices Able to accurately document and communicate issues Experience building effective relationships with internal and external customers Preferred qualifications: Associate's Degree Medical Device or Pharmaceutical background Exposure and working knowledge within Salesforce Relocation assistance is not available for this position at this time. Boston Scientific will not offer sponsorship or take over sponsorship of an employment VISA for this position at this time.
The Reimbursement Pre-Authorization Specialist II is responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department. Work Mode: Remote in country Onsite Location(s): United States Additional Location(s): N/A Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance At Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information, and training, we'll help you in advancing your skills and career. Here, you'll be supported in progressing whatever your ambitions. Day Shift - Flexible Hours Your responsibilities will include: Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service Create electronic folders for new patients Organize patient medical records in preparation for prior authorization and appeals process Answers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome Communicates and builds relationships with HCP offices and Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits etc. Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases Coordinates with lead and supervisor regarding complicated cases Required qualifications: High School Diploma Minimum 3-year Insurance Pre-Authorization Reimbursement experience Experience working with various payors including, Medicare, Medicaid and Private Payor, as it relates to medical procedures, services, and devices Able to accurately document and communicate issues Experience building effective relationships with internal and external customers Preferred qualifications: Associate's Degree Medical Device or Pharmaceutical background Exposure and working knowledge within Salesforce Relocation assistance is not available for this position at this time. Boston Scientific will not offer sponsorship or take over sponsorship of an employment VISA for this position at this time.