Reimbursement Specialist

7 days ago


Pittsburgh, Pennsylvania, United States ZOLL Services LLC (on SAM site) Full time

Job Summary:

The Reimbursement Specialist plays a vital role in the Cardiac Management Solutions division of ZOLL Medical Corporation. This position is responsible for ensuring timely authorization of services for patients, working closely with insurance carriers, physician offices, and sales staff to obtain necessary documentation and clinical information.

Key Responsibilities:

  • Initiate and reauthorize services with insurance carriers for established patients
  • Obtain necessary documentation, including updated clinical information and forms, as dictated by the payer
  • Communicate with clients, physician offices, and sales representatives to relay or obtain pertinent information and documentation
  • Complete weekly follow-up with physicians or sales teams to obtain updated clinical information for existing patients
  • Negotiate favorable rates with insurance carriers to guarantee assignment of benefits and determine appropriate fee schedules for the billing process

Requirements:

  • H.S. Diploma or equivalent required; Bachelor's degree preferred
  • Superior communication and customer service skills, with the ability to handle multiple tasks simultaneously under strict deadlines
  • Minimum of 1-2 years' experience in customer service, medical insurance verification, benefits, or a related area; or Bachelor's degree and 1 year of relevant experience
  • Strong negotiation skills
  • Experience working with all payer types, including Medicare, Medicaid, and third-party commercial insurance companies
  • Proficiency in MS Excel, email programs, and online data systems

Working Conditions:

This position is generally performed in a typical office environment that is usually quiet. Employee is expected to work collaboratively with team members, as well as able to work independently with limited supervision. Work will require significant computer and telephone work.

Physical Requirements:

While performing the duties of this Job, the employee is regularly required to sit, talk, and hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 25 pounds.



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