(OMS) Authorization Specialist

Authorization Specialist

Change people's lives and love what you do! Cochlear is the most recognized brand in hearing health care.

If you have a passion for working with health insurance providers and are looking for an opportunity to develop your knowledge and grow professionally, this is a fantastic opportunity to join the Reimbursement OMS team at the global leader in implantable hearing devices! In this role, you will be based in our Americas head office based in Lone Tree, CO. This role is hybrid, requiring you to be in the office 2 days per week (Wednesday and Friday) minimum, with 3 days per week working from home.

In this role the Authorization Specialists is responsible for advocating for and obtaining candidate coverage for Cochlear's implantable technologies by processing requests for authorization support and to meet customer needs. You will utilize operational resources to enter and manage surgical authorizations and provide full-cycle management of cases through payor determination. You will also leverage your experience to educate both clinicians and patients regarding coverage and payor processes.

Key Responsibilities :

Provide full life-cycle management of surgical authorization cases.

Verify eligibility, investigate insurance benefits and validate coverage.

Verify insurance process for submission of pre-surgical authorizations.

Navigate and utilize operational resources to enter and manage authorization requests according to insurance process, urgency and workflow prioritization.

Collect documentation based on payor requirements and HIPAA compliant process.

Evaluate medical documentation for accuracy, requirements and validity and submit to insurance for prior authorization.

Follow-up with insurance companies and customers according to operational requirements

Other duties as assigned

Key Requirements :

Bachelors or Equivalent Work Experience

2-3 years of experience ideally working with health insurance, including but not limited to :

Knowledge of CPT-4 and ICD-10 codes

Insurance eligibility and benefit verification

Understanding of insurance and healthcare billing processes

Salary and Benefits :

Target Salary Rate : $24.00 - $26.75 per hour based upon experience, as well as an annual bonus opportunity of 5% of base salary. Compensation offered to candidate may vary based on work experience, education and / or skill level.

Benefit package includes medical, dental, vision, life and disability insurance as well as 401(K) matching with immediate vesting, Paid Time Off, tuition reimbursement, maternity and paternity leave, Employee Stock Purchase Plan and pet insurance.

Human needs have always been our inspiration, ever since Professor Graeme Clark set out to create the first multi-channel cochlear implant because he saw his father struggle with hearing loss. We always start with people in mind thinking about their needs.

For this reason, our products, services and support will continue to evolve and improve. We are by our customers' side through the entire hearing journey, so they can experience a life full of hearing. Our employees tell us that the number one reason they enjoy working for Cochlear is the opportunity to make a difference to people's lives and working in an organization where they can be part of bringing the mission to life each day.

The physical and mental demands described below are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the individual is regularly required to be in a stationary (seated / standing) position; utilize business technology for work product delivery, communicate orally and in writing with others internal or external to the organization, utilize problem solving / critical thinking skills to discern and convey information. May be asked to occasionally transport / move up to 30 pounds, depending on the position. Specific vision abilities required by this job include ability to adjust focus. The individual is regularly required to utilize comprehension, critical thinking, communication, problem solving, organization reasoning, relating to others and discernment of items such as product specifications, procedures and processes to customers (whether internal or external). Influence, organization / classification of information and planning are also required. The work environment is a home / office environment and are representative of those an individual encounters while performing the essential functions of this job.

Apply now by completing your application form online. Applicants must meet the job specific application criteria to be considered. Cochlear Americas is an Equal Opportunity Employer. We will provide reasonable accommodations for qualified individuals with disabilities. If you require accommodation with completing the online application, please contact us via web or phone at 303-264-2549.