Hearing Health Care Specialist

2 weeks ago

Saint Paul, Minnesota, United States Cochlear Full time
About Cochlear

Cochlear is a global leader in implantable hearing devices, dedicated to helping people hear and be heard. Our mission is to bring people closer to the sounds and experiences that enrich their lives.

Job Summary

We are seeking a skilled Prior Authorization Specialist to join our Reimbursement Operations team. As a key member of our team, you will be responsible for facilitating pre-claim activity for reimbursement orders, providing exceptional service to internal and external customers, and working collaboratively with cross-functional business partners.

Key Responsibilities
  • Verify eligibility, investigate insurance benefits, and validate coverage
  • Collect documentation based on payor requirements and medical professional preferred method
  • Evaluate medical documentation for accuracy, requirements, and validity and submit to insurance for prior authorization when required
  • Manage first-level appeals in response to prior authorization denials
  • Communicate professionally, effectively, and clearly with customers to ensure understanding and meet the customer need
  • Secure in-network exceptions and negotiate one-time agreements with insurance payors in which Cochlear is nonparticipating
  • Engage with cross-functional business partners to support reimbursement processes, orders, and customers
Requirements
  • Bachelor's degree or equivalent work experience
  • 2-3 years of experience working with health insurance, including insurance verification, prior authorization, coordination of benefits, and out-of-pocket cost estimate calculations
  • Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships
  • Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier, and email)
  • Excellent verbal and written communication skills
What We Offer

Cochlear offers a competitive salary and benefits package, including medical, dental, vision, life, and disability insurance, as well as 401(K) matching with immediate vesting, Paid Time Off, tuition reimbursement, maternity and paternity leave, Employee Stock Purchase Plan, and pet insurance.

Join Our Team

Cochlear is an Equal Opportunity, Affirmative Action Employer and provides equal employment opportunity to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, marital status, veteran status, or any other characteristic protected by federal, state, or local law.

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