Electromed, Inc.

Human Resources

• Submitting and monitoring continuation-of-care authorizations, as well as obtaining new authorizations when insurance changes occur for existing patients ensuring uninterrupted SmartVest therapy and preventing delays in billing
• Serving as a liaison between patients, healthcare providers, and insurance companies by verifying benefits, submitting timely re-certification requests, and efficiently managing both approval and denial outcomes
• Verify insurance eligibility and DME benefits
• Comprehensively navigate payer websites
• Competently communicate with payers, clinics, PCP’s
• Effectively submit insurance requests to obtain authorization(s) and referrals
• Communicate effectively with Reimbursement Team, such as Patient Account Liaisons and Patient Services
• Educate patients on complex reimbursement situations
• Accurately record information to internal Patient Database
• Handle denied recertifications in a timely manner by obtaining needed documentation and forwarding to the Appeals Team
• Review documentation for updated patient demographics, insurance information, prescription requirements, and medical records per payer guidelines
• Complete other miscellaneous tasks as needed to help support the reimbursement team

Authorization and Benefits Specialist