SME, Verification of Benefits
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Job Location:
Lake Mary, FL - USA
Hourly Salary:
$ 20 - 41
Posted on:
13 hours ago
Vacancies:
1 Vacancy
Job Summary
JOB DESCRIPTION:
Job Title
SME Verification of Benefits
Working at Abbott
At Abbott you can do work that matters grow and learn care for yourself and your family be your true self and live a full life. Youll also have access to:
- Career development with an international company where you can grow the career you dream of.
- Employees can qualify forfree medical coverage in ourHealth Investment Plan (HIP) PPOmedical plan in the next calendar year.
- An excellent retirement savings plan with a high employer contribution.
- Tuition reimbursement the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelors degree.
- A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
- A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity working mothers female executives and scientists.
The Opportunity
This position works out of our Orlando Florida location in the Abbott Heart Failure Acelis Connected Health business. Our Heart Failure solutions are helping address some of the Worlds greatest healthcare challenges. As the SME Verification of Benefits youll have the chance to assist our patients in having accurate insurance information on file and collecting authorizations or PCP referrals as needed.
What Youll Work On
The following reflects managements definition of essential functions for this job but does not restrict the tasks that may be assigned. Management may assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.
Contacts insurance companies to verify status of customer benefits. Files pre-authorizations for new and ongoing services with insurance companies and follow up for an outcome.
Files Appeals to insurance companies as needed
Gathers all necessary documents as requested by insurance companies.
Maintains customer records in practice management system related to coordination of benefits authorizations denials appeals outcomes and communication with insurance company.
Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification authorization appeals and outcomes for services of care.
Provides customers with information regarding their status which may include: developing financial breakdowns for the patient giving the patient estimates of costs and collecting co-pays if applicable.
Assist in coordination of Single Case Agreements for non-contracted plans
Applies knowledge of company procedures contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes.
Assist employees in understanding tasks and department processes and workflow
Organize and distribute daily tasks as needed
Provides feedback to management regarding department tools workflow and payer outcomes that impact department processes and handling
Work with Quality and Process team on department tools and work instructions
Assists with employee on boarding and ongoing training Assists or leads department projects
Point of contact to assist other departments on escalated issues or reported incidents or raise to management
Performs other related duties as assigned.
Required Qualifications
High School diploma or GED required
Two or more years experience in VAD insurance benefits verification and prior authorizations
Excellent verbal and written communication skills including ability to effectively communicate with internal and external customers.
Must be able to work under pressure and meet deadlines while maintaining a positive attitude and providing exemplary customer service
Ability to work independently and to carry out assignments to completion within parameters of instructions given prescribed routines and standard accepted practices
Understand the process for verification of benefits as it relates to the policies and procedures for effective placement of medical services.
Complete Understanding of Medicare Rules and Regulations
Understanding of Managed Care as it relates to benefits and authorizations
Advanced MS Office experience with an emphasis on MS Excel desired
Continued Self Improvement courses & seminars related to position along with In House programs provided by Acelis Connected Health/Abbott.
Preferred Qualifications
Associates Degree preferred
Knowledge in Contracting and Fee Schedules
Strong Computer/Software Skills
Learn more about our health and wellness benefits which provide the security to help you and your family live full lives:
Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer committed to employee diversity.
Connect with us at on Facebook at and on Twitter @AbbottNews.
The base pay for this position is
$20.85 $41.75/hourIn specific locations the pay range may vary from the range posted.
JOB FAMILY:
Customer Service
DIVISION:
HF Heart Failure
LOCATION:
United States > Lake Mary : 1101 Greenwood Boulevard
ADDITIONAL LOCATIONS:
WORK SHIFT:
Standard
TRAVEL:
Not specified
MEDICAL SURVEILLANCE:
Not Applicable
SIGNIFICANT WORK ACTIVITIES:
Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day) Continuous standing for prolonged periods (more than 2 consecutive hours in an 8 hour day) Continuous walking for prolonged periods (more than 2 hours at a time in an 8 hour day)Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.
EEO is the Law link - English: EEO is the Law link - Espanol:
Key Skills
- Sales Experience
- Microsoft Office
- Customer Service
- Communication skills
- Microsoft Outlook
- Microsoft Word
- Business Management
- Benefits Administration
- Microsoft Excel
- Insurance Sales
- Customer relationship management
- Human Resources
About Company
WHO WE ARE CREATING LIFE-CHANGING TECHNOLOGY From removing the regular pain of fingersticks as people manage their diabetes to connecting patients to doctors with real-time information monitoring their hearts, from easing chronic pain and movement disorders to testing half the world’s ... View more
