The Medicare Advantage Specialist is responsible for conducting and facilitating the insurance verification and prior authorization processes for StimLabs’ products, specializing in Medicare Advantage payors. This is a front-line position in a fast paced, results driven environment. Responsibilities include but not limited to: data entry, benefit verification, prior authorization support, denial/appeals management, coding and billing guidance, and other duties as necessary.
RESPONSIBILTIES
- Initiate and coordinate the insurance verification and prior authorization processes for physicians, hospitals, and ambulatory surgery centers for all company products
- Perform a detailed insurance verification for all products and applicable procedures
- Research prior authorizations and aid the customer in the appeals process
- Answer technical reimbursement questions for providers, billing and coding staff, and sales representatives
- Analyze data and draw valid and logical conclusions based on information provided by insurers and documented medical policies
- Answer technical reimbursement questions for providers, billing and coding staff, and sales representatives
- Report territory trends to leads and identify areas for process improvement
- Research customer questions as necessary and communicate with appropriate members of the team to ensure customers receive the highest level of customer service
- Assist the team leads and managers in reporting, trending, and on-going training as required
- Perform related duties as assigned
REQUIREMENTS
- Bachelor’s degree in a related field preferred
- Experience in medical billing and coding in the office, hospital, or ASC settings
- Experience in a reimbursement-based call center environment
- Excellent customer service skills.
- Ability to multitask
- Ability to communicate effectively
- Strong organizational skills; attention to detail
- Strong interpersonal skills
- Must be able to obtain and maintain required credentialing to perform job.
COMPANY
StimLabs is a regenerative medicine company guided by our desire to innovate and create optimized healing solutions. By bringing together a unique set of skills across tissue engineering, pharmaceuticals, and medical devices, we're reimagining what's possible in regenerative medicine. Our staff, our quality system, and our physical workspace were all meticulously selected with the future in mind.StimLabs is home to some of the top tissue engineers, inventors, and thought leaders in the healthcare industry.
Combined, these individuals have more than 100 years of experience in healthcare.
OUR CULTURE
We're looking for like-minded individuals who are forward-thinking, hard-working, and self-motivated. We pride ourselves in hiring genuine people who can work collaboratively towards our vision. We have a united culture where everyone from quality and operations to marketing and product development works together as a team.StimLabs was founded in 2015 with a desire to advance the state of regenerative medicine. In pursuit of this goal, StimLabs has gathered exceptional scientific and clinical minds to develop and commercialize new bioactive technologies.
While current technologies in medical devices, pharmaceuticals, and tissue banking provide useful products, StimLabs believes in the untapped synergy at the intersection of these independent domains. In the first steps towards this vision, StimLabs has launched a suite of next-generation amniotic-derived products. The success of these initial offerings has created a foundation on which StimLabs will continue building the future of regenerative medicine.Apply for this job
