MEDLINE INDUSTRIES Verification Specialist - Tissue Regeneration in Northfield, Illinois

This job was posted by https://illinoisjoblink.illinois.gov : For more information, please see: https://illinoisjoblink.illinois.gov/ada/r/jobs/5095113 Responsible for benefit verification of all insurance coverage and provide high quality customer service to physician offices, Hospital outpatient setting (Wound Care Centers, ASC, Outpatient OR). Responsibilities include verifying insurance with national and government payers, etc. Verify the patient's allowable and deductible amounts, provide assistance with pre-certification and prior authorization when necessary. Work Activities include effectively interface with payers, medical doctors? offices, hospital outpatient centers, and sales representatives to assist providers in starting the patient on Medline?s products and ensure the highest level of coverage status is attained for the product.nn


+ Verify eligibility and determine patient benefit coverage and product allowable.

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+ Contact the providers offices/Hospital Outpatient Centers to resolve intake issues when necessary.

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+ Complete pre-certification/authorization. Obtain additional information such as medical necessity, letter of medical necessity or charts notes to submit for prior authorization when required by the Insurance Carrier.

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+ Respond to emails from customers and sales reps timely. Communicate with other division staff to resolve issues that may present.

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+ Communicate with providers, Sales Reps, and reimbursement director as necessary to problem solve.

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+ Maintain a timely turnaround for insurance verification 24-48 hours for customer response. Provide excellent phone customer service.

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+ Track intake data each month (denials, non-covered, investigational, prior authorization needed, turnaround time)

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+ Ensure HIPAA compliance and protects patients protected health information while performing insurance verification. Maintain confidentiality of all information.

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Medline offers a business casual, entrepreneurial work environment with strong growth potential, a competitive compensation package, and a complete benefits package including medical/dental/vision/life insurance; 401(k) with company match. And much more!

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