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Pre-Authorization Specialist I Job

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Date: Feb 4, 2019

Location: Marlborough, MA, US, 01752

Company: Boston Scientific

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Purpose and Passion • Comprehensive Benefits • Life-Work Integration • Community • Career Growth

At Boston Scientific, you will find a collaborative culture driven by a passion for innovation that keeps us connected on the most essential level. With determination, imagination and a deep caring for human life, we’re solving some of the most important healthcare industry challenges. Together, we’re one global team committed to making a difference in people’s lives around the world. This is a place where you can find a career with meaningful purpose—improving lives through your life’s work.


About the role:

The Pre-Authorization Specialist I is responsible for performing the initial benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department. The Pre-Authorization Specialist I is responsible for providing competitive levels of support to the internal team, Health Care Professional offices, and BSC sales representatives. They are also responsible for answering incoming calls received through the Reimbursement Services Department ACD line.  


Your responsibilities includes:

  • Answers incoming calls received through the toll free Pre-Authorization Support ACD and provide appropriate call/case handling.
  • Performs initial benefit verification and pre-surgical authorization for new pre-surgical cases by working closely with all payers
  • Documents case status, actions, and outcome in the Pre-Authorization Support  contact management database utilizing  who, what, where, when, how
  • Communicates and builds relationships with HCP offices and sales representatives in regards to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
  • Responsible for notifying the appropriate internal departments based on receipt of information that department needs to be aware of including complaint handling/ adverse event notifications 
  • Utilizes customer service skills in engaging with customers, communications with Sales representatives, and working in teams in a call center environment to expedite processing of cases.


What we're looking for:

Basic Qualifications

  • High School diploma or Equivalent
  • 1+ year's experience in Insurance Reimbursement, Customer Service, or Medical device industry is require
  • Must be able to understand the complexities of the Insurance Reimbursement work flow and related processes.  .
  • Must have basic understanding of Medicare, Medicaid, Private Payer, and Workers compensation coding, coverage, and payment as it relates to medical procedures, services, and devices
  • Must possess strong computer skills and have working knowledge of Microsoft outlook, Microsoft Word and Excel.  Must be able to type minimum of 45 wpm
  • Must have exceptional organizational skills and a keen attention to detail, and be multi-task oriented
  • Must demonstrate ability to effectively build relationships and communicate with both internal and external customers
  • Must be able to accurately document and verbalize issues and have the ability to work with in a team environment and across departments  
  • Must be able to work in an environment where meeting and executing on timelines is essential.  MUST be a team player
  • Must be able to work in a fast pace environment in which information is constantly changing; must be able to embrace changes


Preferred Qualifications

  • College undergraduate degree strongly preferred.  Some college preferred.


About us

As a global medical technology leader for more than 35 years, our mission at Boston Scientific (NYSE: BSX) is to transform lives through innovative medical solutions that improve the health of patients. If you’re looking to truly make a difference to people both around the world and around the corner, there’s no better place to make it happen.


Boston Scientific is an Equal Opportunity Employer – Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Disability, Veteran


Requisition ID: 437700


Nearest Major Market: Boston

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