Respiratory Health Specialist

14 hours ago


Saint Paul, Minnesota, United States Advanced Respiratory Full time
Job Summary

We are seeking a highly skilled Respiratory Health Specialist to join our team at Advanced Respiratory. As a key member of our organization, you will play a critical role in ensuring that patients receive the necessary medical care and support.

Key Responsibilities
  • Verify patient eligibility and benefits to determine coverage and payer requirements.
  • Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims.
  • Gather clinical documentation to support medical necessity for Respiratory Health products.
  • Assess clinical documentation to ensure all applicable prescription, face-to-face, and coverage criteria requirements are met.
  • Prepare and submit prior authorization requests to insurance companies, including commercial payers and government payers.
  • Negotiate payment rates for letter of agreement to ensure maximum collection potential.
  • Provide exceptional customer service by communicating effectively with patients, healthcare teams, and insurance companies.
Requirements
  • Associate's degree or higher preferred.
  • 3+ years of industry experience, preferably in health insurance and/or durable medical equipment.
  • Third-party payer experience strongly preferred.
  • Exceptional written, verbal, and interpersonal communication skills.
  • Strong critical thinking and problem-solving skills.
  • Detail-oriented and ability to multi-task.
  • Ability to work independently and in a team environment.
  • Proficiency in Microsoft Office software.
What We Offer

At Advanced Respiratory, we are committed to providing a supportive and inclusive work environment. We offer a competitive salary range of $41,600 to $57,200 annually, as well as opportunities for professional growth and development.

We are an equal opportunity employer and welcome applications from diverse candidates. If you are passionate about making a difference in the lives of patients and their families, we encourage you to apply for this exciting opportunity.



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