eSight is an organization with a simple but profound belief: that people who can see the world, can change the world.
This belief has driven us to invent a truly novel technology - breakthrough, electronic glasses that let the legally blind actually see. This solution dramatically transforms the lives of the legally blind, with thousands of stories online that are likely to leave you with a lump in your throat or a tear in your eye.
We are a well-funded, cutting-edge organization that is passionately driven by our vision to change the world with life-changing, customer-centric technology. We are currently looking for a US DME Reimbursement Specialist, to assist doctors and their patients in obtaining coverage payment for DME that restores vision, but not covered routinely.
In this role, you’ll be responsible for interfacing with patients, company sales and/or service representatives, optometrists, ophthalmologists and their bill staff, and insurance carriers to handle a variety of pre-sales and post-sales service functions in the area of DME insurance reimbursement. You will play an instrumental role in helping people to see again.
More about this role:
- Refers patients to appropriate center for medical evaluation. Act as liaison, where necessary, to facilitate completion of evaluation.
- Verify benefits, prepare and file pre-authorization requests and medical claims. Complete standard follow-through calls and monitor status of case until approved.
- Maintain and update medical insurance database; understand full consequences for input into database. Provide reporting as needed.
- Assist in preparing materials for presentation to clinics and insurers, e.g., appeals packages, updates for Insurance Guidebook, and related materials.
- Facilitates communication between insurers, clinics and patients to expedite exchange of require data
- Establish working relationship with centers’ billing staff. Answer telephone inquiries and obtains necessary information to set up patient charts and maintain files.
- Coordinate with team with regard to complicated and problem cases and assist in appeals process.
- Perform other related duties as assigned, including special projects.
The ideal candidate will:
- Have experience in DME billing for commercial insurers, Medicaid, and Medicare. Familiar with billing miscellaneous codes, obtaining prior authorizations, and advancing appeals on denials.
- Communicates with ease to medical personnel, insurance representatives, customers and their families. Have knowledge of the language of the medical profession. Be able to facilitate and educate, where necessary, between medical profession and customers.
- Exercise diplomacy, persistence, attention to detail in all facets of position. Sound administrative skills, to include written correspondence composition, and verbal communication skills in dealing with difficult situations.
We’re looking for:
- Experience in medical insurance required.
- Experience with medical device prior authorization preferred. DME experience preferred. Experience with miscellaneous DME codes preferred.
- High school diploma or equivalent required; college undergraduate degree preferred.
This is a full-time, permanent position conveniently located @Yonge and Eglinton, direct access from the TTC station. eSight offers competitive compensation package, including health and dental benefits and an amazing work culture!
At eSight we are committed to fostering an inclusive, barrier-free and accessible environment. Part of this commitment includes arranging accommodations to ensure an equitable opportunity to participate in the recruitment and selection process. If you require any accommodation during the application or interview process, we will work with you to meet your needs. Please contact us at 1 855 837 4448 x317.