Reimbursement Pre-Authorization Specialist II
Boston Scientific Gruppe - Arden Hills, Minnesota, United States,![Boston Scientific Gruppe](/api/image?src=https%3A%2F%2Fgeneral-board-default.s3.us-east-2.amazonaws.com%2Fpublic%2Fimages%2Fdesk-360x180.webp&w=640&q=75&f=webp)
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Onsite Location(s): Arden Hills, MN, US, 55112Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High PerformanceAt 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.About the role: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.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 outcomes.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.Experience building effective relationships with internal and external customers.Exposure and working knowledge within Salesforce.Preferred qualifications:Associate’s Degree.Able to accurately document and communicate issues.Medical Device or Pharmaceutical background.Prior or current Boston Scientific experience within reimbursement.Requisition ID:
584098As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate.At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. Boston Scientific is proud to be an equal opportunity and affirmative action employer.
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