Are you looking to make a meaningful impact in the lives of stroke survivors?  Are you organized, customer-focused and interested in joining a high-performing team in a start-up environment? MicroTransponder, inc. is seeking a highly motivated Pre-Service Clearance Specialist to help bring a new therapy to stroke survivors – the ViviStim® Paired VNS™ Therapy. 

You will be an integral part of the Market Access and Reimbursement Team and the primary point of contact for all patient intake, prior authorization, denials management and other reimbursement-related support.  The Pre-Service Clearance Specialist coordinates payer eligibility and payment verification to provide exceptional customer service experience to our sales teams and provider’s offices nationwide.  Success in this position facilitates patient access to the ViviStim® Paired VNS™ Therapy, which helps stroke survivors regain their dignity and independence.

This position has the potential for rapid upward mobility for the candidate with managerial aspirations.  You will be located at the stunning HULA Lakeside offices in Burlington, VT with free on-site parking and numerous on-site amenities, including gym membership and outdoor recreational activities at the Burlington Surf Club.

Responsibilities

  • Develop awareness and understanding of the coverage policy landscape for vagus nerve stimulation (VNS) and rehabilitation therapies to treat upper limb deficit in patient’s with chronic stroke symptoms
  • Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements for ViviStim® Paired VNS™ Therapy
  • Obtain, document and store appropriate patient medical records from multiple office and sources
  • Request, track and obtain pre-authorization from insurance carriers within time allotted
  • Initiate appeals for denied authorizations
  • Confirm accuracy of CPT and ICD-10 diagnoses
  • Clearly document all communications and contacts with providers office, patient, sales team and MicroTransponder personnel in databases
  • Leveraging insurance coverage databases, identify and communicate any insurance changes or trends among team
  • Support hospital and rehabilitation clinics to identify and appeal denied services including provision of denial appeal templates
  • Demonstrate and apply knowledge of medical terminology
  • High proficiency in medical office operations including HIPAA regulations.
  • Respond to clinic questions regarding payer medical policy guidelines and authorization status
  • Other duties as assigned

Required Skills/Qualifications

You should have a strong understanding of pre-service clearance procedures and processes and be able to apply that in a fast-paced environment.  This position requires careful attention to detail and Regular updates, occasional presentations to senior management and strong communication skills are required of this strong team player.

  • Experience in medical front-office operations and/or pre-service clearance
  • Experience in reviewing, handling and storing medical record documentation and awareness of HIPAA compliance programs
  • Demonstrated acumen and success in securing prior authorization, ideally for neurostimulation implant surgery and/or physical therapy services
  • Experience and understanding of the billing process for hospital and/or physician services to Medicare and commercial insurance plans
  • Ability to review and understand explanation of benefits and remittance advice documents
  • Experience in claims processing, billing, patient financial services and claim denial appeals a plus

Education & Work Requirements

  • Bachelor’s degree or combination of education and highly relevant experience
  • 2 years of medical prior authorization experience preferred
  • 2 years experience in a medical related field required
  • Coding certification (i.e. CPC) and/or practice management designations preferred (i.e. RHIA, RHIT, PACS)
  • Additional startup or small company experience preferred
  • Neurostimulation or rehabilitation experience preferred

This is a full-time role with competitive compensation that is commensurate with experience. 

 

MicroTransponder, Inc. (www.microtransponder.com) is a privately held medical device development company with a strong neuroscience research focus. An experienced team of scientists and engineers has developed a neurostimulation technology platform to treat neurological conditions, including post-stroke motor rehabilitation and tinnitus.

Apply for this Job

* Required