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Reimbursement Specialist
2 weeks ago
Insulet started in 2000 with an idea and a mission to enable our customers to enjoy simplicity, freedom and healthier lives through the use of our Omnipod® product platform. In the last two decades we have improved the lives of hundreds of thousands of patients by using innovative technology that is wearable, waterproof, and lifestyle accommodating.
- We are looking for highly motivated, performance driven individuals to be a part of our expanding team. We do this by hiring amazing people guided by shared values who exceed customer expectations. Our continued success depends on it
Job Title: Reimbursement Specialist, Bilingual
FLSA Status: Non-Exempt
Position Overview:
**Responsibilities**:
- Understand Insulet insurance contracts, channeling and processing requirements for all covered products.
- Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.
- Submission of all prior authorization requests for approval and payment of Insulet products at time of claim processing.
- Calculate and document cost share amounts for potential customers, both for our English-speaking customers as well as our French[1]speaking customers.
- Collaborate with other commercial teams such as Case Management, OmniPod Sales and Billing, to ensure proactive communication of potential customer’s order status.
- Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.
- Provide frequent feedback and suggestions to support an environment of continuous process improvement.
- Performs other duties as required.
Education and Experience:
Minimum Requirements:
- Completion of Post Secondary Certificate or Diploma
- English required, bilingual strongly preferred.
Preferred Skills and Competencies:
- Bachelor’s Degree preferred.
- 2-4 years’ medical device, pharmaceutical, healthcare or consumer product related field preferred.
- Knowledge and understanding of the managed care industry is preferred.
- Knowledge of and experience supporting patients with diabetes is preferred.
- Experience with Salesforce or other CRM system is preferred.
- The ability to work overtime to meet business objectives is required.
Preferred Skills and Competencies:
- Communication Skills: Delivers oral and written communications that make an impact and persuade their intended audiences. Effectively handles interactions at all levels and appropriately responds to sensitive situations. Expresses oneself clearly in conversations, interactions, and in writing. Oral Communication - The ability to express oneself clearly in conversations and interactions with others in both English and French. Written Communication - The ability to express oneself clearly in business writing, in both English and French.
- Results Orientation: Focuses on the solution and drives for positive resolution and results consistently. Demonstrates persistence and creative problem-solving skills to address obstacles and challenges to deliver successful outcomes.
- Collaboration and Teamwork: Collaborates and works effectively with other team members to produce optimal results.
- Accountability: Demonstrates ownership and resolve for producing high quality work product and exceptional service. Ensure agreements and commitments throughout the process are fulfilled in a timely manner.
- Effective Self-Management and Action Orientation: Thrives in a fast-paced environment and operates with a sense of urgency and passion for achieving sales goals. Demonstrates the ability to work well under pressure and maintain composure in the face of difficult and/or challenging situations. Effectively handles multiple challenges or tasks through prioritization and multi-tasking. Appropriately escalates issues requiring additional support to manager.
Physical Requirements (if applicable):
- Requires sitting and standing associated with a normal office environment.
- Manual dexterity needed for using a computer keyboard.
- Lightweight lifting may be required.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
