Insurance Verification Subject Matter Expert at Medtronic

Pune, Maharashtra, India

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medical DevicesIndustries

Requirements

Bachelor’s degree in business or accounting major is preferred
4 to 6 years of Insurance Verification experience in a US healthcare environment
Experience with reading and understanding medical policy information, and utilizing insurance benefit and coverage information to calculate estimated patient responsibility, taking into consideration pre-determination, referral, authorization, and contract terms
Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA’s) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination
Experience with HIPAA guidelines and healthcare compliance
Previous experience in receiving and making outbound calls to patients to explain insurance benefits related to health insurance, and/or discussing patient financial responsibilities

Responsibilities

Follow prescribed policies and procedures, performs a variety of verification tasks using standard healthcare guidelines
Provides eligibility and insurance verification support to product sales teams by working assigned tasks within service level agreements
Utilizes the system, and/or contact the patient to obtain basic policy, plan and group numbers for all insurance carriers on the patient’s account to confirm eligibility
Interact with insurance carriers/patients/websites to conduct comprehensive insurance benefit verifications for all insurance carriers with confirmed eligibility on the patient’s account
Document insurance eligibility and benefits within the customer account to ensure accurate and timely billing for current and future customer orders
Collaborate with internal and external customers to assist our patients with questions on obtaining Medtronic products, therapy, troubleshooting, health insurance coverage concerns, transferring patients to the appropriate department as needed
Enters data into computer systems using defined resources and programs, and investigates questionable data, and recommends actions to resolve discrepancies

Skills

Key technologies and capabilities for this role

Insurance VerificationEligibility VerificationBenefit VerificationPatient Financial ServicesCustomer ServiceHealthcare GuidelinesInsurance CarriersClaim ProcessingDiabetes Care

Questions & Answers

Common questions about this position

What education and experience are required for this role?

A Bachelor’s degree in business or accounting is preferred, along with 4 to 6 years of Insurance Verification experience in a US healthcare environment.

What are the main responsibilities of the Insurance Verification SME?

The role involves performing insurance eligibility and benefit verification tasks, interacting with insurance carriers and patients, documenting benefits in customer accounts, and collaborating with internal and external customers to support patients.

Is this a full-time position?

Yes, this is a full-time employment opportunity.

What is the location of this job?

This information is not specified in the job description.

What salary or compensation does this role offer?

This information is not specified in the job description.

Medtronic

Develops and manufactures medical devices and therapies

About Medtronic

Medtronic provides medical technology, services, and solutions to improve patient care. The company develops a variety of medical devices, including pacemakers, insulin pumps, surgical tools, and neurostimulation devices, which help diagnose, prevent, and treat chronic diseases. These products are used by hospitals, clinics, and healthcare professionals around the world. Medtronic stands out from competitors by investing significantly in research and development to create new products and offering additional services like training and patient management programs. The goal of Medtronic is to enhance patient outcomes and lower healthcare costs through its comprehensive range of medical solutions.

Fridley, MinnesotaHeadquarters

1949Year Founded

$3.2MTotal Funding

IPOCompany Stage

Biotechnology, HealthcareIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Vacation

Paid Sick Leave

Paid Holidays

401(k) Retirement Plan

401(k) Company Match

Employee Stock Purchase Plan

Employee Assistance Program

Wellness Program

Risks

Emerging competitors like Fire1 threaten Medtronic's heart failure management market share.

Spine biologics market growth may attract new entrants, increasing competition for Medtronic.

Recent IPOs in medtech indicate rising competition, challenging Medtronic's market position.

Differentiation

Medtronic's diverse product range spans cardiovascular, diabetes, neurological, and surgical technologies.

The company invests heavily in R&D to drive innovation in medical devices.

Medtronic offers comprehensive services, including training and technical support, enhancing product value.

Upsides

Exclusive deal with Kuros enhances Medtronic's orthopedic portfolio and market share.

Growing spine biologics market offers expansion opportunities in spinal fusion and regenerative medicine.

Balloon catheters market growth aligns with Medtronic's recent product launches, boosting cardiovascular presence.

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