Insurance Support Services Specialist I

Job Type


Full-time

Description

About MED-EL

MED-EL Corporation is a global leader in hearing implant technology and research. Headquartered in Austria with U.S. operations based in Durham, North Carolina at Research Triangle Park, we are driven by innovation and a passion for restoring the joy of sound. Our hearing implant systems combine cutting-edge scientific research, engineering, and manufacturing to deliver exceptional performance, safety, and reliability.

People are at the center of everything we do. We relentlessly pursue connection-connection to sound, to one another, and to new possibilities. Our diverse, team-focused culture reflects our commitment to supporting candidates, recipients, families, and clinical partners.

Our Mission: Delivering leading-edge technology to restore hearing and empower connection.

Insurance Support Services Specialist I

Location: Durham, NC (Research Triangle Park)

Schedule: On-site during onboarding (~90 days), hybrid schedule available after completion


Department: Insurance Support Services


Reports To: Supervisor, Insurance Support Services

The Insurance Support Services Specialist I is responsible for processing health insurance orders by verifying medical coverage, obtaining authorizations, and managing authorization denials and appeals. This role ensures compliance with industry standards while delivering exceptional service to internal and external customers.

Primary Responsibilities

• Answer calls from physician offices, hospitals, and patients using exemplary customer service skills.
• Accurately enter required information into databases to ensure proper and timely billing of claims.
• Follow established procedures for submitting authorizations and verifying eligibility.
• Determine member benefit coverage for requested items.
• Maintain communication with patients and providers regarding authorization status and any funds due.
• Maintain patient confidentiality per state, federal, and company regulations.
• Build cooperative working relationships with colleagues, clinicians, patients, and families.
• Support departmental and corporate strategic plans.
• Assist accounts receivable staff with researching unpaid claims related to eligibility or authorization issues.
• Perform daily administrative and general office duties related to reimbursement.
• Follow confidentiality and privacy protocols in accordance with HIPAA.
• Use problem-solving and conflict-resolution skills when handling patient complaints.

Alternate / Secondary Responsibilities

• Serve as a resource to clinicians and support staff regarding authorizations and insurance requirements.
• Maintain knowledge of federal, state, local, and intermediary-specific billing requirements.
• Notify appropriate personnel of missing or incomplete billing requirements and follow up promptly.
• Maintain understanding of government rules and regulations.
• Stay informed on coding and reimbursement changes for all payors.
• Perform other reimbursement-related tasks as assigned.

Job Tasks

• All duties listed above are performed daily.

Required Skills

• Alignment with MED-EL values through performance and behavior.
• Strong mathematical skills for computing and adjusting balances, claims, and billing.
• Experience using health plan portals for verification and authorization.
• Excellent written and verbal communication skills.
• Strong customer service skills for internal and external stakeholders.
• Exceptional time management, attention to detail, and organizational skills.
• Strong computer, multitasking, and phone skills.
• Demonstrated critical thinking, creativity, and problem-solving abilities.
• Knowledge of CPT, HCPCS, and ICD-9/10 coding systems.
• Understanding of medical billing software with the ability to learn quickly.
• Ability to work well under pressure and with minimal supervision.

Education & Experience

• High school diploma or equivalent required.
• Minimum 2 years of insurance or revenue cycle experience preferred.
• Experience with insurance verifications, authorizations, denials, and appeals strongly preferred.

Training Requirements

• Quality System (QS) documents assigned by QS Manager.
• Training and Guidance documents assigned by Training & Development Manager or Supervisor.

Additional Requirements

• Work materials (including computers) are provided for business use.
• In temporary remote-work situations (e.g., weather emergency, office closure), employee must maintain an appropriate home work environment with reliable internet access.
• MED-EL is not responsible for costs associated with home office setup.
• On-site presence required daily during the initial onboarding period (~90 days).
• Hybrid schedule available after successful onboarding.
• Employee must maintain a suitable home work environment, including high-speed internet, for hybrid work.