UNIV - Hearing Aid Reimbursement and Payer Relations Specialist - Department of Otolaryngology

Medical University of South Carolina • Charleston, SC

3d

About The Position

The Hearing Aid Reimbursement and Payer Relations Specialist manages all aspects of hearing device reimbursement, payer policy oversight, and financial performance. This role verifies insurance benefits, interprets coverage policies, supports prior authorizations, ensures accurate coding and claim submission, and mitigates denials. Serving as the primary liaison with insurance carriers, the specialist monitors policy updates, supports contract and pricing alignment, and analyzes reimbursement trends to protect margins. The position collaborates with clinical, billing, finance, and compliance teams to standardize workflows, ensure regulatory compliance, and provide data-driven reporting to support operational and financial decision-making.

Requirements

• A high school diploma and three years professional experience in a related area such as accounting, auditing, finance or commercial lending.
• A bachelor's degree with multiple accounting courses may be substituted for two years of the required work experience.
• Computer literacy.

Nice To Haves

• Strong knowledge of insurance policy interpretation
• Understanding of managed care contracts
• Familiarity with healthcare coding and reimbursement systems
• Analytical and financial acumen
• Strong communication and negotiation skills
• Regulatory awareness

Responsibilities

• Reimbursement & Benefits Verification: Verify hearing aid benefits and coverage prior to patient appointments, interpret policies, determine prior authorization requirements, estimate patient financial responsibility, and communicate coverage details.
• Payer Relations & Policy Management: Serve as the primary contact for insurance carriers, monitor policy updates, escalate coverage denials, maintain payer-specific guidelines, and support contract negotiations.
• Pricing & Financial Oversight: Monitor manufacturer pricing and reimbursement trends, ensure pricing aligns with payer rates, analyze margins, and provide financial impact analysis.
• Revenue Cycle & Compliance: Ensure correct coding, support clean claim submission, track denials, develop mitigation strategies, and ensure regulatory compliance.
• Data & Reporting: Track reimbursement turnaround time, revenue per device, prepare reports for leadership, and identify operational improvement opportunities.
• Collaboration: Work with audiologists, division/department leadership, revenue cycle/billing, compliance, and finance. Educate providers and staff, and create internal workflows.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED