Senior Change of Benefits Specialist

Location: Remote, PA

Cardiac Management Solutions

The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest® wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies. Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives. ZOLL has been Pittsburgh’s Manufacturer of the Year, one of Western PA’s Healthiest Employers, and even one of Pittsburgh’s Coolest Offices. But it’s our unique opportunity to impact people’s lives that makes ZOLL the ideal place to build your career.

Job purpose

The Change of Benefits Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of accounts with a change of insurance coverage. This individual will work with numerous insurance types in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest. Individual is responsible for creating and maintaining relationships with insurance companies, sales team, and other internal departments.

Duties and responsibilities

  • Act as the point of contact for issues of moderate complexity relative to the COB process

  • Assign workload to COB staff to effectively provide coverage as necessary (batch results, exceptions, RT tickets)

  • Retrieve and process batch eligibility and discovery files

  • Perform all regular COB duties as dictated by the needs of the business and ensure timely completion

  • Ensure all Change of Benefits are billed in a timely manner to maximize revenue opportunities, increase cash flow, and close segment/month end timely

  • Monitor HIPAA compliance within department

  • Ensure timely processing of tickets within all queues assigned to the Change of Benefits department

  • Provide coaching to COB Specialists as needed

  • Assist in tracking and reporting in these areas

  • Organize and deliver regular team huddles

  • Respond to escalations from sales team in a timely manner

  • Identify areas of opportunity to improve processes along with aiding in the implementation of those changes

  • Responsible for creating and documenting SOP’s for department use

  • Performs other duties as directed by Management

Qualifications

  • H.S. Diploma or equivalent required. Associate’s or Bachelor’s degree in nursing, business, or other related field preferred

  • 2-3 years insurance verification experience

  • Superior communication; both verbal and written

  • Strong customer service skills

  • Proficiency in navigating several software systems concurrently

  • Aptitude to handle multiple tasks simultaneously under strict deadlines

  • Attention to detail

  • Superior organizational and time management skills

  • Ability to communicate policy information in a clear and detailed manner

  • Proficiency with MS Office Suite

Working conditions

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 The noise level in the work environment is usually quiet.

Physical requirements

The physical demands described here are representative of those that must be met by an employee 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 employee is regularly required to sit and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Supervisory responsibility

None

AAP/EEO Statement

ZOLL is committed to fostering an inclusive workplace, where unique identities, backgrounds, cultures, perspectives and experiences are respected and valued.

Equal Opportunity Employer – Disability and Veteran

ZOLL now mandates COVID vaccinations subject to legal exemptions.

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