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Health Insurance Verification Specialist – Remote – Atos Medical – Insurance Department – Laryngectomy Care Leader

Remote Full-time Live

Join the Atos Medical Team as a Health Insurance Verification Specialist and Make a Difference in the Lives of People with Laryngectomy Atos Medical, a global leader in laryngectomy care and a part of Coloplast A/S, is seeking a highly skilled and compassionate Health Insurance Verification Specialist to join our Insurance Department. As a key member of our team, you will play a vital role in ensuring that our customers, who have undergone a laryngectomy, receive the necessary products and services to improve their quality of life. If you have a passion for delivering exceptional customer service, a strong understanding of insurance verification processes, and a desire to make a positive impact, we encourage you to apply for this exciting opportunity. About Atos Medical Atos Medical is a specialized medical device company dedicated to providing innovative solutions for people living with a neck stoma. With a strong purpose-driven culture, we design, manufacture, and sell our products directly to leading institutions, healthcare professionals, and patients. Our mission is to give a voice to people who breathe through a stoma, and we achieve this through our 1400 dedicated employees worldwide. As a leader in laryngectomy care, we are committed to making life easier for people living with a neck stoma, and we believe that everyone should have the right to speak, even after cancer. Job Summary The Health Insurance Verification Specialist will be responsible for supporting Atos Medical's mission by assisting with the attainment of our products through the insurance verification process and reimbursement cycle. This role requires a high level of customer service skills, insurance management knowledge, and analytical abilities. As a Health Insurance Verification Specialist, you will analyze and offer advice to our customers regarding insurance matters, interact with internal team members, and negotiate with insurance payers to ensure a smooth order process workflow. Key Responsibilities:

  • Insurance Verification and Authorization: Act as an advocate for our customers in relation to insurance benefit verification, obtain and secure authorization or pre-certifications required for patients to acquire Atos Medical products, and verify the accuracy and completeness of patient account information.
  • Customer Service and Communication: Answer incoming calls from insurance companies and customers, educate customers, staff, and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends.
  • Collaboration and Negotiation: Collaborate with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations. Contact insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for customers.
  • Documentation and Record-Keeping: Maintain knowledge of and reference materials of Medicare, Medicaid, and third-party payer requirements, guidelines, and policies, insurance plans requiring pre-authorization, and a list of current accepted insurance plans.
  • Other Duties: Complete all Insurance Escalation requests as assigned, inquire about gap exception waivers from out-of-network insurance payers, educate medical case reviewers at Insurance Companies about diagnosis and medical necessity of Atos Medical products, and obtain single case agreements when requesting an initial authorization with out-of-network providers.

Requirements and Qualifications Essential Qualifications:

  • Education: High School Diploma or G.E.D.
  • Experience: Experience in customer service in a healthcare-related industry.

Preferred Qualifications:

  • Experience: 2+ years of experience with medical insurance verification background.
  • Licenses/Certifications: Medical coding and billing certifications preferred.
  • Software: Experience with following software preferred: Salesforce, SAP, Brightree, Adobe Acrobat.
  • Knowledge: Knowledge of Medicare, Medicaid, and third-party payer requirements, guidelines, and policies, insurance plans requiring pre-authorization, and a list of current accepted insurance plans.

What We Offer

At Atos Medical, we offer a comprehensive benefits package, including:

  • Flexible Work Schedules: Flexible work schedules with summer hours.
  • Market-Aligned Pay: Market-aligned pay.
  • 401k Plan: 401k dollar-for-dollar matching up to 6% with immediate vesting.
  • Comprehensive Benefit Plan: Comprehensive benefit plan offers.
  • Flexible Spending Account (FSA): Flexible Spending Account (FSA).
  • Health Savings Account (HSA): Health Savings Account (HSA) with employer contributions.
  • Life Insurance, Short-term and Long-term Disability: Life Insurance, Short-term and Long-term Disability.
  • Paid Paternity Leave: Paid Paternity Leave.
  • Volunteer Time Off: Volunteer time off.
  • Employee Assistance Program: Employee Assista

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