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Reauthorization Specialist

Location: Pittsburgh, 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.

The Reauthorization Specialist is an integral member of the reimbursement team and has primary responsibility for the timely initiation of reauthorizations with insurance carriers for established patients. The representative will also be in contact with physician offices for additional clinical information, progress notes and additional testing if required.


Essential Duties and Responsibilities:

  • Communicates medical need and educates case manager on LifeVest system to obtain authorization for services. Works with insurance carriers to authorize service for existing patients.

  • Negotiates favorable rates with insurance carriers to guarantee assignment of benefits and determine appropriate fee schedules for the billing process.

  • Obtains necessary documentation as dictated by payer, including clinical information not already on file (medical order, clinical notes, patient agreement, etc.), updated or continued usage documentation and medical criteria eligibility.

  • Assists team members with clinical interpretation of patient's record during reauthorization process.

  • Contacts the client, physician office and sales representative to relay or obtain pertinent information and documentation to ensure continued coverage.

  • Completes weekly follow up with physicians to obtain updated clinicals for existing patients. Interacts with sales staff as needed to obtain required documentation.

  • Responsible for generation of all reauthorization requests based on initial expiration.

  • Performs other duties as assigned by Management.

Supervisory Responsibilities:  None


Qualifications:  To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skills and abilities required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.

Educations and/or Experience:

  • H.S. Diploma or equivalent required. 

  • Superior communication and customer service skills, and ability to handle multiple tasks simultaneously under strict deadlines. 

  • 3-5 years’ experience in medical insurance verification.

  • Strong negotiation skills.

  • Experience working with all payer types to include Medicare, Medicaid and third party commercial insurance companies.

  • Superior communication, customer service skills and strong phone presence.

  • Ability to handle multiple tasks simultaneously under strict deadlines.

  • Proficiency in MS Excel, email programs and online data systems.

Language Skills:  Ability to read and comprehend simple instructions, short correspondence, and memos.  Ability to write simple correspondence.  Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.


Mathematical Skills:  Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. 

Reasoning Ability:  Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems and make appropriate judgment calls to insure the correct outcome.

Computer Skills:  To perform this job successfully, an individual should be proficient in Microsoft Office Suite.

Physical Demands: 

  • 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 frequently required to sit, walk, talk and hear.  Employee may occasionally be required to lift and carry up to 25 pounds.

Work Environment:

  • 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.


ZOLL is an Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.