Location: Greenville, South Carolina, United States
Job Type: Contact Center
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Job Description
Process all aspects of the order process by verifying insurance benefits/coverage to determine eligibility and calculate cost share amounts for existing and new customers.
Requesting and collecting updated documentation, prior authorizations, order entry and coordinating shipment of product to customers.
Must maintain a thorough understanding of products offered by the client.
Understand the clients channeling and processing requirements for all covered products, which is based on medical policy and payer guidelines.
Work as part of the larger support team, collaborating with other departments to ensure proactive, superior front-line customer support.
Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.
Provide frequent feedback and suggestions to support an environment of continuous process improvement.
Serving as a department expert on all client insurance contracts, channeling and processing requirements for all covered products.
Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.
Submission of all prior authorization requests for approval and payment of the clients products at time of claim processing.
Calculate and document cost share amounts for potential customers.
Collaborate with other commercial teams such as Case Management, Sales and Billing, to ensure proactive communication of potential customer’s order status.
Using their advanced knowledge and skill set, this position could be called upon to complete a wide range of task within the Reimbursement team.
