LivaNova is a global medical technology company built on nearly five decades of experience and a relentless commitment to improving the lives of patients around the world. Our advanced technologies and breakthrough treatments provide meaningful solutions for the benefit of patients, healthcare professionals, and healthcare systems. The company is listed on the NASDAQ stock exchange under the ticker symbol “ LIVN .” LivaNova is headquartered in London (UK) with a presence in over 100 countries and a team of more than 3,000 employees worldwide.
RESPONSIBILITY AND AUTHORITY
This position is responsible for the gathering and coordination of information regarding patient benefits, prior authorization and pre determination. Additionally, provides support to providers and payers regarding VNS Therapy reimbursement to ensure patients are eligible for benefits for VNS Therapy.
This position is authorized for financial expenditures/commitment levels as defined by the Cyberonics, Inc. Global Authority Matrix.
PRIMARY ACTIVITIES
Level I
- Handles receipt and data entry of all incoming faxes including PIQs/IVEAs and patient medical records in a timely manner.
- Creates new opportunities in SLX as needed when new PIQs/IVEAs come in.
- Performs self -assessment of all activities to ensure accuracy.
- Verifies for completeness of incoming Insurance Verification forms
- Completes insurance verifications on behalf of the health care provider within 48-72 hour turn-around period
- Assists with identification of VNS Therapy policies with payers in the area of responsibility
- Handles scanning and electronic storage of incoming hard copy correspondence
- Performs other duties as may be required by management
Level II
- Performs Level I duties in addition to the following:
- Assist Case Management with payer data collection
- Maintains Verification FAQs and updates as needed
Level III
- Performs Level I & II duties and
- Oversees training of new verification specialists and provides continued support
- Assist with device tracking and web request for information
- Assists Case Managers with maintenance of Sales Logix including accuracy of contact and account information
- Assists Department Manager/Director (All Levels) with special projects
- Performs quality monitoring as assigned.
- Maintain users and organization on Availity Web Portal
- Monitors all state Medicaid websites for updated policy information as well as check for new PA forms on at least a yearly basis.
ADDITIONAL ACTIVITIES
Assist Case Managers in providing information to referring physicians via fax as requested
TRAVEL REQUIREMENTS
This position does not require business travel.
MINIMUM REQUIREMENTS AND QUALIFICATIONS
- High school diploma or equivalent
- Good organizational skills with attention to detail
- Good telephonic ability
- Familiarity with Word, Excel, PowerPoint, Microsoft Outlook programs
- Excellent written and verbal communication ability is a must
- Coding/Billing software experience or relevant experience
- Previous experience in office and/or hospital coding and billing, prior authorization experience at the office or hospital setting (preferably with a neurology or neurosurgeon practice) or relevant experience
- Knowledge of health insurance industry practices/functions to include Medicare, Medicaid and all types of commercial and managed care organization’s coverage policies
- Strong work ethics
- High level of integrity
- Ability to work overtime, as required
- The minimum requirements, skills and qualifications contained in this job description outline the core functions and requirements of the position and do not constitute an exhaustive listing of activities, duties, or responsibilities that may be required of or assigned to an employee in this position at the Company’s discretion. Further, the ability to meet the minimum requirements and/or possession of the stated skills and qualifications do not imply or establish that an individual will be employed in this position.
DESIRED SKILLS AND QUALIFICATIONS
Level 1 – Specialist, Verification I 1 to 2 years relevant experience.
Level 2 – Specialist, Verification II Meets Level I requirement and has 5 or more years of experience with ICD-9/ICD-10 and CPT coding, medical terminology, or relevant experience.
Level 3 – Specialist, Verification III Meets all Verification Specialist level I and II qualifications with 10 years or more relevant experience Demonstrated skill in coaching/leading others.
Employee benefits include:
- Health benefits – Medical, Dental, Vision
- Personal and Vacation Time
- Retirement & Savings Plan (401K)
- Employee Stock Purchase Plan
- Training & Education Assistance
- Bonus Referral Program
- Service Awards
- Employee Recognition Program
- Flexible Work Schedules