Sr. Manager, Insurance

1 month ago

Somerset, United States Demant Full time
Overview

Oticon Medical is a Hearing Implant company providing solutions for those with hearing losses that a hearing aid cannot treat. The Sr. Manager, Insurance is responsible for the direction and oversight of the insurance team and accountable for delivering a best-in-class customer experience from them.

Responsibilities
  • Develops a culture, procedures and policies that lead to a best-in-class customer experience with focused health insurance acumen.
  • Responsible for the strategic intent and operations of the insurance team.
  • Collaborates with the relevant commercial and clinical groups within Oticon Medical to maximize coverage and reimbursement for all current and future products.
  • Drafts, implements, and executes policies and procedures to facilitate a quality and compliant customer experience.
  • Establishes service levels and requirements for the department including role-based performance metrics.
  • Develops and implements methods to record, assess, and analyze customer feedback.
  • Manages direct reports and will be responsible for their performance and development
  • Understands the healthcare and Medicare/Medicaid/private insurance environments, and tracks changes that can affect future reimbursement and policy expansion.
  • Proactively identifies, assesses and communicates key policy, reimbursement and contracting issues (including utilization management and prior authorization)
  • Leads an internal Insurance Services team through referral/order receipt, medical record review, benefits investigation, pre-authorization approval and denial appeals and claims preparation and submission.
  • Coordinates claims/enrollment/collections with other departments within the company.
  • Develops and implements training and quality assurance programs for new hires and experienced employees.
  • Identifies and recommends expansions to technology, equipment, and policies that may improve service and retention.
  • Acts as a liaison between the insurance and customer service department and other divisions in the company.
  • Drafts, implements, and manages the department’s budget.
  • Holds oneself and others accountable to conduct business in a manner compliant within Oticon Medical’s Code of Conduct, policies and procedures and internal controls applicable to their role.
  • May perform miscellaneous tasks/projects as directed by the General Manager.
Qualifications
  • 5+ years of experience in Insurance/Reimbursement (DME preferred) and prior management experience
  • Bachelor’s degree required; advanced degree preferred.
  • Expert knowledge of reimbursement, government/commercial payer requirements (Medicare, Medicaid, Commercial, VA, etc). Process-oriented with strong analytical and problem-solving skills.
  • Experience working in customer-facing roles
  • As a manager of high performance, customer-facing teams, the candidate must possess Leadership qualities.
  • Excellent verbal and written communication skills.
  • Excellent interpersonal and customer service skills.
  • Excellent organizational skills and attention to detail.

The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

#LI-RW1 #OTM

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