Pre-Authorization Specialist Job

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Purpose and Passion Comprehensive Benefits Life-Work Integration Community Career Growth

At Boston Scientific, you will find a collaborative culture driven by a passion for innovation that keeps us connected on the most essential level. With determination, imagination and a deep caring for human life, we're solving some of the most important healthcare industry challenges. Together, we're one global team committed to making a difference in people's lives around the world. This is a place where you can find a career with meaningful purposeimproving lives through your life's work.

Pre-Authorization Specialist

About the role:
The Pre-Authorization Specialist is responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department.

** Multiple opportunities available **

Your responsibilities will include:

• Answers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling
• Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers
• Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome
• Communicates and builds relationships with HCP offices and sales representatives in regards to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
• Notifies the appropriate internal departments based on receipt of information that department needs to be aware of including complaint handling/adverse event notifications
• Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases
• Maintains current metric standards
• Provides competitive levels of support to the functions of the internal team, Health Care Professional offices, and BSC sales representatives
• Suggests continuous process improvements
• Coordinates with lead and supervisor with regard to complicated cases

What we’re looking for in you
Minimum Qualifications

• High School Diploma
• Minimum 1-year Insurance Pre-Authorization Reimbursement experience
• Experience working with various payors including, Medicare, Medicaid, Private Payor, and Workers Compensation as it relates to medical procedures, services, and devices
• Able to accurately document and verbalize problems
• Experience building effective relationships with internal and external customers
• Proficient in MS Word, Excel

Preferred Qualifications

• Bachelor’s Degree

• Medical device experience

About us

As a global medical technology leader for more than 35 years, our mission at Boston Scientific (NYSE: BSX) is to transform lives through innovative medical solutions that improve the health of patients. If you're looking to truly make a difference to people both around the world and around the corner, there's no better place to make it happen.

Requisition ID:473896