Insurance Verification Specialist

📋 Description

• Verify patient insurance eligibility, benefits, and coverage for advanced wound care and cellular
• Conduct benefit investigations with commercial, Medicare, Medicaid, and managed care payers.
• Determine patient financial responsibility, including deductibles, copayments, coinsurance, and
• Manage eligibility and reimbursement cases; communicate with payer case managers, providers, sales
• Escalate complex eligibility and reimbursement issues to stakeholders.
• Review payer policies and coverage criteria for wound care therapies.

🎯 Requirements

• At least 5 years in patient access, reimbursement support, medical billing, coding, or related
• Expertise in prior authorizations, appeals, benefit investigations, and verification.
• Strong knowledge of Medicare/Medicaid and payer policies/processes.
• Experience with CPT, HCPCS, ICD-10-CM as related to wound care.
• High school diploma; associate or bachelor's degree preferred.
• Experience in wound care or related therapeutic areas preferred.

🎁 Benefits

• Permanent, full-time employment
• Remote work arrangement within the United States
• Opportunity to support patient access to wound care and therapies
• Collaborative environment with providers, payers, and teams
• Develop expertise across patient access, reimbursement, and healthcare market access
• Exposure to Medicare/Medicaid policies and evolving reimbursement requirements