Pre-Authorization Specialist II

Additional Location(s): N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.

Shift Hours: 8:00 AM - 5:00 PM (Some Flexibility)

About this role:

The Reimbursement Pre-Authorization Specialist II 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.

Work Mode

At Boston Scientific, we value collaboration and synergy. This role follows a remote work model. This role is 100% remote

Relocation

Relocation assistance is not available for this position at this time.

VISA

Boston Scientific will not offer sponsorship or take over sponsorship of an employment VISA for this position at this time

Your responsibilities will include:

• Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service
• Create electronic folders for new patients
• Organize patient medical records in preparation for prior authorization and appeals process
• 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 Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
• 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
• Coordinates with lead and supervisor regarding complicated cases

Required qualifications:

• 1-2 years of direct pre-authorization experience.
• High School Diploma and/or Equivalent experience, training , or apprenticeships
• Minimum 3-year Insurance Pre-Authorization Reimbursement experience
• Experience working with various payors including, Medicare, Medicaid and Private Payor, as it relates to medical procedures, services, and devices
• Able to accurately document and communicate issues
• Experience building effective relationships with internal and external customers

Preferred qualifications:

• Associate’s Degree
• Medical Device or Pharmaceutical background
• Exposure and working knowledge within Salesforce

Requisition ID: 624011

Minimum Salary: $38688

Maximum Salary: $65728

The anticipated compensation listed above and the value of core and optional employee benefits offered by Boston Scientific (BSC) – see will vary based on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be hired near the bottom or top of the anticipated salary range listed above.

Compensation for non-exempt (hourly), non-sales roles may also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).

Compensation for exempt, non-sales roles may also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements).

For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.

As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do – as a global business and as a global corporate citizen.

So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!

At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve.

Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identity, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.