Inside Wholesaler responsible for cultivating and maintaining relationships with RBC Insurance Brokers. Collaborating with Sales Consultants to achieve sales plans and develop producer acquisition strategies.
About the role
- Wound Care Verification/Authorization Specialist verifying patient eligibility for health care services at InfuSystem. Collaborating with healthcare providers for necessary authorizations and documentation support in a hybrid work environment.
Responsibilities
- Review and verify patient insurance and confirm patient’s eligibility and benefits specific to Advanced Wound Care and Negative Pressure Wound Therapy
- Use Medicare portal to verify patient’s hospital or skilled nursing status
- Initiating, following up, and securing authorizations on from third party payors based on payer requirements for a variety of wound care related HCPCS codes
- Track and follow up on all pending authorizations within the timeframe designated by management to expedite the claims process.
- Process authorizations electronically, utilizing payer portals, fax, or telephone working with the payers to secure authorizations retrospectively and/or requesting single case agreements for out of network patients
- Obtain authorization renewals, verify physician written orders are active, and certification of medical necessity is in place
- Work closely with NPWT Customer Care team to ensure supporting documentation is received to obtain authorizations timely
- Verify authorization quantities and effective dates are returned and processed correctly by the third-party payers, and loaded correctly in all systems
- Organize work to avoid lost revenue due to filing limitations
- Input the correct Payer Plan ID# and enter data into appropriate systems to ensure accurate billing for current and future services
- Determine the extent of liability for insurance plans, coordination of benefits, and patient financial responsibility.
- Interact with third-party insurance companies to secure retroactive authorizations, and/or single case agreements for out of network patients, where applicable
Requirements
- Associate degree (A. A.) or equivalent; two to four years related experience and/or training; or equivalent combination of education and experience.
- Familiar with insurance payers and medical benefits
- Minimum of two years’ experience in a healthcare setting
- Organizational skills
- Medical terminology
- Good troubleshooting skills
- Ability to work as a team
- Ability to independently meet tight deadlines in a project-based atmosphere
- Follows department processes and procedures
- Highly motivated and detail-oriented
Benefits
- Health plan options that include an employer contribution
- Health Savings Account (HSA)
- Healthcare and Dependent Care Flexible Spending Accounts (FSA)
- Dental and Vision premiums covered by InfuSystem
- Life Insurance, STD & LTD
- Paid Parental Leave
- Adoption and Fertility Assistance
- 401(k) with a specified Company Match
- Employee Stock Purchase Program
- Tuition Assistance
- Generous Paid Time Off plan
- Employee Assistance Program
- Competitive Pay
- Employee Referral Bonus
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Licensed Insurance Advisor providing trusted insurance advice for home and auto solutions at RBC. Focused on delivering excellent client experience while achieving sales goals.
Life, Health & Wealth Advisor providing comprehensive insurance and financial advice at RBC Insurance. Building client relationships through business development, networking, and effective opportunity spotting.
Verzekeringsadviseur Agrarisch developing sustainable relationships with agricultural clients. Responsible for acquiring new clients while maintaining existing accounts in the Noord - Oost region.
Insurance and Senior Services Coordinator responsible for enrollment into senior - related insurance policies and providing client support. Maintaining databases and planning community programs for seniors while delivering exceptional customer service.
Team Leader overseeing Claims Payments in Short Term Insurance at Absa Bank. Leading a team to achieve cost - effective claims service delivery with a focus on compliance and operational excellence.
Insurance Agent responsible for growing personal insurance clientele and maintaining client relationships for McClain Matthews Insurance. Seeking to maximize relationships through effective client management and sales.
Examiner - in - Charge leading examinations of captive insurance companies within Vermont Department of Financial Regulation. A focus on operations, compliance, and financial reporting for oversight of these companies.
Insurance Coordinator at Mercer Advisors executing insurance coverage tasks and managing policies across product lines. Engaging with clients, brokers, and internal departments for policy management and client service.
Reinsurance Officer coordinating reinsurance processes among departments like Finance, Actuarial, and Underwriting at AIG. Overseeing contract compliance and maintaining broker relationships.