Funding Payer Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with the Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier, and office support staff to execute operational procedures in accordance with company policies and timelines.

• Assist in obtaining payer authorization and compile necessary information and documentation for funding packages.

• Ensure all documentation is thorough to achieve quality authorizations for equipment and repairs.

• Serve as the account manager for designated work orders by liaising with funding areas and completing tasks via work queues and reports.

• Oversee the transaction cycle from the "Ready to Submit" stage to the "Final Funding Approval."

• Confirm the required documents for payer submission are accurate.

• Collaborate with funding colleagues to obtain any missing documentation.

• Verify insurance coverage and benefits information.

• Request and secure prior authorizations, pre-determination, and denial notices as necessary.

• Conduct post-authorization quality assurance checks before logging the authorization.

• Communicate with payers, branch staff, clients, and others to obtain authorization and gather information.

• Investigate deferrals and provide updates regarding payer documentation requirements.

• Share relevant trends with Funding Leaders.

• Maintain communication with clients throughout the process when appropriate.

• Follow up with payer sources in accordance with work queue requirements, policies, and escalation procedures.

• Perform other related duties as assigned by the Funding Director, Manager, or Supervisor.

⛳️ Requirements

• Minimum of 2 years' experience in Complex Rehab Technology, Medical Billing, or Funding is preferred.

• High school diploma or G.E.D. is required.

• Proficient in Microsoft Excel, Word, and Outlook.

• Demonstrate a professional demeanor with minimal supervision.

• Completion of all continuing education requirements, including designated NSM University courses.

• Regular and reliable attendance is essential.

• Ability to talk, hear, sit, use hands repetitively, and reach with hands and arms in an office setting.

🏝️ Benefits

• 401k plan.

• Company-funded Long Term Disability coverage.

• Tuition reimbursement program.

• Opportunities for continuing education through assigned NSM University courses.