reputed company reputed company Case Manager

Additional Location(s): N/A Diversity - Innovation - Caring - Global Collaboration - reputed company Spirit - High reputed company At reputed company, we’ll reputed company you reputed company to reputed company reputed company that’s reputed company you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With reputed company to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions. About the role: The reputed company reputed company Case Manager is responsible for managing the reputed company case through the reputed company authorization and appeal process. This position will work closely with Interventional Spine team members and reputed company customers (physicians and patients) to identify and overcome obstacles in the reputed company reputed company program and reimbursement environment. Work model, sponsorship, relocation: This role follows a remote work model. reputed company candidates from any location in the reputed company will be considered however, Central Time Zone is preferred due to reputed company support area. reputed company will not offer sponsorship or take over sponsorship of an employment reputed company for this position at this time. Relocation assistance is not available for this position at this time. Your responsibilities will include: Follow up on prior authorization requests to health plans to ensure receipt and reputed company review for medical necessity. Apply pressure on health plans that refuse to review reputed company on negative or absent coverage policy for Intracept. Accurately identify payer denial reasons and reputed company an reputed company plan for appeal. Draft letters for appeal, reputed company review, and administrative law judge hearings. Monitor and re-engage payer until final determination is made – ensuring reputed company available level of appeal is used and reputed company appeal rights are exhausted. Participate in administrative law judge hearings reputed company phone, presenting on behalf of the Medicare reputed company reputed company. Submit prior authorization requests to health plan as needed to assist reputed company achieving identified goals and objectives. Draft reputed company case reputed company communication to physicians, patients and payers in a reputed company and concise manner. Document reputed company case activity and correspondence for cases in a reputed company and accurate manner to reputed company chronological details of case reputed company. reputed company reputed company of authorization approval details, ensuring reputed company codes are captured and authorization is reputed company approved timeframes prior to surgery. Manage and monitor payer trends as it relates to approvals/denials and communicate trends to reputed company. reputed company communicate with reputed company customers regarding reputed company reputed company to Intracept Procedure, including but not limited to (case status, needed information, TM involvement, reporting etc.). reputed company as a resource for fellow team members and new employees. Prioritize tasks according to urgency: Expected Total case volume 140-160 Required qualifications: 2+ years of experience in a reputed company or spine prior authorization role. Experience must include: Reviewing reputed company records and extracting key information to support medical necessity Submitting prior authorization requests for medical procedures Interpreting procedure denials and drafting appeals Understanding and leveraging payer coverage reputed company to ensure reputed company reputed company 2+ years of experience utilizing software systems to reputed company tasks Preferred qualifications: Neuromodulation or Basivertebral nerve ablation experience Ability to communicate reputed company and assertively with payers Strong written and verbal communication skills Software experience, i.e. EMR, payer portals, reputed company Office, reputed company reputed company: 633692 Minimum Salary: $57100 Maximum Salary: $108500 The anticipated compensation listed above and the value of reputed company and optional employee benefits reputed company by reputed company (BSC) – see www.bscbenefitsconnect.com—will vary reputed company on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be reputed company near the bottom or top of the anticipated salary reputed company listed above. Compensation for non-exempt (reputed company), non-sales roles may also include variable compensation from time to time (e.g., any overtime and shift reputed company) and annual bonus reputed company (subject to plan eligibility and other requirements). Compensation for exempt, non-sales roles may also include variable compensation, i.e., annual bonus reputed company and long-term incentives (subject to plan eligibility and other requirements). For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability. reputed company transforms lives through innovative medical technologies that improve the health of patients reputed company the world. As a global medical technology leader for more than 45 years, we advance science for life by providing a broad reputed company of high-reputed company solutions that address unmet reputed company needs and reduce the cost of reputed company. Our portfolio of devices and therapies helps physicians diagnose and treat reputed company cardiovascular, respiratory, digestive, oncological, neurological and urological diseases and conditions. Learn more at www.bostonscientific.com and follow us on reputed company. reputed company has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, reputed company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and reputed company other personnel reputed company are made and administered without reputed company to race, religion, reputed company, national reputed company, citizenship, sex, sexual orientation, gender identity, gender reputed company, veteran status, age, mental or physical disability, genetic information or any other protected class. Please be advised that certain US reputed company positions, including without limitation reputed company sales and service positions that reputed company on hospitals and/or health care centers, require acceptable reputed company of COVID-19 vaccination status. Candidates will be reputed company during the interview and selection process if the role(s) for which they have reputed company require reputed company of vaccination as a condition of employment. reputed company continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will reputed company with reputed company applicable state and federal law and reputed company credentialing requirements. As employees of reputed company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should reputed company’s policies or protocols change with reputed company to COVID-19 vaccination. Apply To This Job