Posted in General Business 13 days ago.
Type: Full-Time
Location: Memphis, Tennessee
Are you ready to work for a more active world?
At Bioventus, our business depends on developing our people. We invest in you and challenge you to be the best. We value our colleagues for their different perspectives and individual contributions, and our leaders listen. Our success rests on working together to achieve shared goals and rewards. Join a diverse team of global colleagues driven to help patients resume and enjoy active lives.
As a Medical Authorization Specialist (MAS) you will support the reimbursement strategy of the company by aggressively pursuing authorization and reimbursement while establishing a resource of expertise to the payers. You will need to demonstrate, through actions, a consistent performance standard of excellence to which all work is to conform.
1. Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans.
2. Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company's products.
3. Verifies health insurance eligibility and benefits for patients specific to DME via phone, payer portals or fax and calculates estimated out of pocket costs.
4. Submits pertinent demographic and supporting clinical documentation with pre-authorization requests timely to avoid unnecessary delays in patient treatment.
5. Maintains and documents complete, timely, and accurate patient insurance and billing information.
6. Performs on-going check and balance system to ensure the integrity of the patient billing data.
7. Operates compliantly at all times by keeping patient data secure and confidential and adhering to all company policies and procedures.
8. Operates compliantly at all times by keeping patient data secure and confidential and ad
9. Coordinates with Sales, Healthcare Providers and applicable internal/external personnel to obtain necessary documentation.
10. Complies with all health, safety and environmental policies, procedures and job hazard analyses applicable to specified job activities; including medical evaluations as required by job function.
11. Completes all required training in a satisfactory and timely manner.
12. Holds oneself and others accountable to conduct business in a manner compliant with Bioventus' Code of Compliance, policies and procedures and internal controls applicable to their role.
13. Other duties as assigned
• High school diploma plus 4 years of related experience or 4-year college degree
• 1 year medical authorization experience involving medical record review required.
• Knowledge and interpretation of medical terminology and ICD-10 coding.
• Must possess good written and oral communication skills with the ability to interface with customers and company personnel at all levels. Strong persuasion/negotiation skills.
• Must display professional persistence, manage detailed information; maintain high level of organization; display strong proficiency in multi-tasking by effectively managing time and priorities.
• PC experience in Microsoft Word, Excel, Outlook or other related software required. Knowledge of SAP or other integrated software applications preferred.
Are you the top talent we are looking for?
Apply now! Hit the "Apply" button to send us your resume and cover letter.
Bioventus is committed to fostering an inclusive and diverse community of employees with a strong sense of belonging. We believe we are bettered by all forms of diversity and take pride in working with top talent from every walk of life. In the spirit of inclusivity, qualified applicants will be considered without regard to age, ethnicity, disability, gender, veteran status, gender expression, gender identity, nationality, race, religion or sexual orientation. All individuals, regardless of personal characteristics, are encouraged to apply.
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