Pre Authorization Specialist II

Boston ScientificSanta Clarita, CA
2d

About The Position

Answers incoming calls received through the toll free Pre-Authorization Support ACD and provides appropriate call/case handling Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers Utilizes advanced knowledge in Microsoft Office and database management to document case status, actions, and outcome Communicates and builds relationships with HCP offices and sales representatives in regards to all inquiries for the handling of cases, i.e., missing case information, benefits etc. Notifies the appropriate internal departments based on receipt of information that department needs to be aware of including complaint handling/adverse event notifications Utilizes advanced customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases Maintains current metric standards Provides competitive levels of support to the functions of the internal team, Health Care Professional offices, and BSC sales representatives Suggests and evaluates continuous process improvements Coordinates with lead and supervisor with regard to complicated cases

Requirements

  • 1-2 Years with High School Diploma and/or Equivalent experience, training , or apprenticeships

Responsibilities

  • Answers incoming calls received through the toll free Pre-Authorization Support ACD and provides appropriate call/case handling
  • Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers
  • Utilizes advanced knowledge in Microsoft Office and database management to document case status, actions, and outcome
  • Communicates and builds relationships with HCP offices and sales representatives in regards to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
  • Notifies the appropriate internal departments based on receipt of information that department needs to be aware of including complaint handling/adverse event notifications
  • Utilizes advanced customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases
  • Maintains current metric standards
  • Provides competitive levels of support to the functions of the internal team, Health Care Professional offices, and BSC sales representatives
  • Suggests and evaluates continuous process improvements
  • Coordinates with lead and supervisor with regard to complicated cases
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