Insurance Verification - Subject Matter Expert
Insurance Verification - Subject Matter Expert
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Job Description
At Medtronic you can begin a life-long career of exploration and innovation while helping champion healthcare access and equity for all. Youll lead with purpose breaking down barriers to innovation in a more connected compassionate world.
A Day in the Life
Medtronic is expanding their footprint for Diabetes Care with a center in Pune and as the Insurance Verification Subject Matter Expert for Patient Financial Services India this role is responsible for all aspects of insurance eligibility and benefit verification including customer service with the objective of minimizing controllable denials and maximizing the clean claim rate within Patient Financial Services.The Diabetes Operating Unitfocuses on improving the lives of those within the global diabetes a business we strive to empower people with diabetes to live life on their terms by delivering innovation that truly matters and providing support in the ways they need it.
Our portfolio of innovative solutions is designed to provide customers greater freedom and better health helping them achieve better glucose control while spending less time managing their disease.
Responsibilities may include the following and other duties may be assigned:
As an Insurance Verification SME for Patient Financial Services the role involves following prescribed policies and procedures performs a variety of verification tasks using standard healthcare guidelines.
Provides eligibility and insurance verification support to product sales teams by working assigned tasks within service level agreements.
Utilizes the system and/or contact the patient to obtain basic policy plan and group numbers for all insurance carriers on the patients account to confirm eligibility.
Interact with insurance carriers/patients/websites to conduct comprehensive insurance benefit verifications for all insurance carriers with confirmed eligibility on the patients account.
Document insurance eligibility and benefits within the customer account to ensure accurate and timely billing for current and future customer orders.
Collaborate with internal and external customers to assist our patients with questions on obtaining Medtronic products therapy troubleshooting health insurance coverage concerns transferring patients to the appropriate department as needed.
Enters data into computer systems using defined resources and programs and investigates questionable data and recommends actions to resolve discrepancies.
Required Knowledge and Experience:
Bachelors degree in business or accounting major is preferred.
4 to 6 years of Insurance Verification experience in a US healthcare environment.
Experience with reading and understanding medical policy information and utilizing insurance benefit and coverage information to calculate estimated patient responsibility taking into consideration pre-determination referral authorization and contract terms.
Experience with various insurance plans offered by both government and commercial insurances (i.e. PPO HMO EPO POS Medicare Medicaid HRAs) and coordination of healthcare benefits including requirements for referral authorization and pre-determination.
Experience with HIPAA guidelines and healthcare compliance.
Previous experience in receiving and making outbound calls to patients to explain insurance benefits related to health insurance and/or discussing patient financial responsibilities.
Physical Job Requirements
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position but they are not an exhaustive list of all the required responsibilities and skills of this position.
Benefits & Compensation
Medtronic offers a competitive Salary and flexible Benefits Package
A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits resources and competitive compensation plans designed to support you at every career and life stage.
About Medtronic
We lead global healthcare technology and boldly attack the most challenging health problems facing humanity by searching out and finding solutions.
Our Mission to alleviate pain restore health and extend life unites a global team of 95000 passionate people.
We are engineers at heart putting ambitious ideas to work to generate real solutions for real people. From the R&D lab to the factory floor to the conference room every one of us experiments creates builds improves and solves. We have the talent diverse perspectives and guts to engineer the extraordinary.
Learn more about our business mission and our commitment to diversity here
Employment Type
Full-Time
