Job Information
Integra LifeSciences Reimbursement Case Specialist in xx, New Jersey
Changing lives. Building Careers.
Joining us is a chance for you to do important work that creates change and shapes the future of healthcare. Thinking differently is what we do best. To us, change equals opportunity. Every day, more than 4,000 of us are challenging what’s possible and making headway to help improve outcomes.
The Reimbursement Case Specialist will work with healthcare providers, field sales representatives, insurance companies and patients to case manage all steps required to gain access to Integra products. The Reimbursement Case Specialist will act as the single point of contact for healthcare providers to obtain ongoing support services related to the fulfillment of Integra products. In this role they will act as the subject matter expert for topics related to reimbursement, local and regional health plan policies, coverage requirements and any other topics impacting product reimbursement. This role will verify insurance coverage of Integra products as well as facilitate insurance benefit verifications, prior authorizations, predeterminations and assist in navigating the claims denial process.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
Primary responsibilities are to:
Verify current insurance coverage policies and benefits specifics through direct contact with medical insurance providers and ensure prompt return of accurate information to healthcare professionals to facilitate ongoing patient care with Integra products.
Assist with the coordination of the case set up with wound care center/ providers, patients and sales representative.
Develop productive working relationships with internal and external field sales representatives to provide coordinated support to healthcare providers and patients interested in treatment with Integra products.
Demonstrate proficiency and full understanding of the Reimbursement Call Center Customer Relationship database including understanding of data elements, definition of various case statuses and outcomes, case documentation requirements and the importance of meeting program metrics.
Provide the highest level of customer service while acting as the single point of contact for healthcare providers to case manage all steps required to gain access to treatment with Integra’s products.
Handle all protected patient data according to strict HIPAA compliance and ethical record-keeping.
Accurately document call details, follow up actions, and any other pertinent information within the Customer Relationship Management database.
Identify and escalate customer concerns and program trends to the Reimbursement Services Manager as well as Reimbursement Call Center team.