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Reimbursement Specialist I Job

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Date: Jan 2, 2021

Location: Valencia, CA, US, 91355

Company: Boston Scientific

Additional Locations: US-MA-Marlborough



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.


Pre-Authorization Specialist


About the role:
The Pre-Authorization Specialist I is responsible for performing proficient 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. This role can sit at our Marlborough, MA or Valencia, CA location.

** Multiple opportunities available **

Your responsibilities will include:

  • Answers incoming calls received through the toll free Pre-Authorization Support ACD and provides appropriate call/case handling
  • Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers
  • Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome 
  • 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.
  • Notifies 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, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases
  • Maintains current metric standards
  • Provides competitive levels of support to the functions of the internal team, Health Care Professional offices, and BSC sales representatives
  • Suggests continuous process improvements
  • Coordinates with lead and supervisor with regard to complicated cases


What we’re looking for in you
Minimum Qualifications

  • High School Diploma
  • Minimum 1-year Insurance Pre-Authorization Reimbursement experience
  • Experience working with various payors including, Medicare, Medicaid, Private Payor, and Workers Compensation as it relates to medical procedures, services, and devices
  • Able to accurately document and verbalize problems
  • Experience building effective relationships with internal and external customers
  • Proficient in MS Word, Excel

Preferred Qualifications

  • Bachelor’s Degree
  • Medical device experience


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


Boston Scientific maintains a drug-free workplace.  Pursuant to Va. Code § 2.2-4312 (2000), Boston Scientific is providing notification that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the workplace and that violations will result in disciplinary action up to and including termination.

Requisition ID: 469601


Nearest Major Market: Los Angeles

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