Intake Specialist-Fully-Remote, Various Shifts

CMS
At ZOLL, were passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in peoples lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.
ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed to deliver better insights and better outcomes. On any given day, clinicians utilize these ZOLL products for tens of thousands of cardiac patients around the world:
LifeVest, the world first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death.
HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent.
TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20 years ago to reduce infarct size in patients with the most severe heart attacks.
Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need.
ZOLL has been Pittsburghs Manufacturer of the Year, one of Western PAs Healthiest Employers, and even one of Pittsburghs Coolest Offices. But its our unique opportunity to impact peoples lives that makes ZOLL the ideal place to build your career.
Job purpose
The Intake Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of new medical orders from hospitals and physician offices. This individual is responsible for front-end functions of the order fulfillment process. Individual will work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest. Individual is responsible for creating and maintaining relationships with insurance companies, sales reps, and other internal departments.
Job purpose
The Intake Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of new medical orders from hospitals and physician offices. This individual is responsible for front-end functions of the order fulfillment process. Individual will work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest. Individual is responsible for creating and maintaining relationships with insurance companies, sales reps, and other internal departments.
Shifts: Mon-Fri 1pm-9:30pm & Wed-Sat 8am-6:30pm (4-10) both fully remote.
Duties and responsibilities
Creation of patient record
Verification of benefits
Triage, work and resolve intake orders
Explain medical need and educate insurance case managers on LifeVest system to obtain authorization for services
Obtain necessary documentation (medical order, clinical notes, testing) and submit to insurance carrier for coverage determination
Obtain authorizations as required by payer
Execute timely follow up on all assigned tasks
Maintain a score of at least Meets Expectations on monthly scorecard
Identify qualifying diagnosis based on payer requirements
Triage fax documents for timely review
Communicate authorization results and order status to sales representatives
Complete fee calculator and inform billing department of appropriate charges
Contact customers, physician offices, and sales representatives to relay and/or obtain insurance information and/or additional documentation to assist with seeking reimbursement and coordination of benefits
Performs other duties as assigned b