Reimbursement Specialist

Maven Wise, LLC is recruiting for an Insurance Reimbursement Specialist to support insurance reimbursement for pre-sales and post-sales service functions with a globally recognized medical devices manufacturer in Valencia, CA.

Here’s your day-to-day:

• Must be able to calculate deductibles and co-pays.
• Verify benefits, prepares pre-authorization requests.
• Document approvals and follow-up with appeals in response to insurance denials.
• Obtains patient information and maintains database of patient files.
• Facilitates communication between insurers, clinics and patients to expedite exchange of required data as it relates to insurance problems.
• Establish working relationship with centers’ billing staff.
• Inbound and outbound telephone inquiries and follow up
• Maintain and update medical insurance database.
• Prepare materials for presentation to clinics and insurers e.g: appeals packages, updates for Insurance Guidebook and related materials.

Your qualifications:

• High School Diploma or GED
• Experience in medical insurance and medical device prior authorization (preferred)
• 3+ years of reimbursement process experience
• Database (SAP, Oracle or JDE), MS Suite
• Strong ability to communicate well with: Medical Personnel, insurance representatives, customers and their families

Job Types: Full-time, Contract, Temporary

Pay: $22.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Hybrid work
• Office

Education:

• High school or equivalent (Required)

*Upon completion of in-person training, remote working may be an option.*