Insurance Verification Subject Matter Expert

At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You'll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world.

Medtronic is expanding their footprint for Diabetes Care with a center in Pune and as the Insurance Verification Subject Matter Expert for Patient Financial Services, India, this role is responsible for all aspects of insurance eligibility, and benefit verification, including customer service, with the objective of minimizing controllable denials and maximizing the clean claim rate within Patient Financial Services.

The Diabetes Operating Unit focuses on improving the lives of those within the global diabetes community. As a business, we strive to empower people with diabetes to live life on their terms by delivering innovation that truly matters and providing support in the ways they need it.

Our portfolio of innovative solutions is designed to provide customers greater freedom and better health, helping them achieve better glucose control, while spending less time managing their disease.

Responsibilities may include the following and other duties may be assigned:

As an Insurance Verification SME for Patient Financial Services, the role involves following prescribed policies and procedures, performs a variety of verification tasks using standard healthcare guidelines.

• Provides eligibility and insurance verification support to product sales teams by working assigned tasks within service level agreements.
• Utilizes the system, and/or contact the patient to obtain basic policy, plan and group numbers for all insurance carriers on the patient's account to confirm eligibility.
• Interact with insurance carriers/patients/websites to conduct comprehensive insurance benefit verifications for all insurance carriers with confirmed eligibility on the patient's account.
• Document insurance eligibility and benefits within the customer account to ensure accurate and timely billing for current and future customer orders.
• Collaborate with internal and external customers to assist our patients with questions on obtaining Medtronic products, therapy, troubleshooting, health insurance coverage concerns, transferring patients to the appropriate department as needed.
• Enters data into computer systems using defined resources and programs, and investigates questionable data, and recommends actions to resolve discrepancies.

Required Knowledge and Experience:

• Bachelor's degree in business or accounting major is preferred.
• 4 to 6 years of Insurance Verification experience in a US healthcare environment.
• Experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to calculate estimated patient responsibility, taking into consideration pre-determination, referral, authorization, and contract terms.
• Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA's) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.
• Experience with HIPAA guidelines and healthcare compliance.
• Previous experience in receiving and making outbound calls to patients to explain insurance benefits related to health insurance, and/or discussing patient financial responsibilities.

Physical Job Requirements

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position.

Medtronic offers a competitive Salary and flexible Benefits Package

A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits, resources, and competitive compensation plans designed to support you at every career and life stage.

This position is eligible for a short-term incentive called the Medtronic Incentive Plan (MIP).

We lead global healthcare technology and boldly attack the most challenging health problems facing humanity by searching out and finding solutions.

Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 95,000+ passionate people.

We are engineers at heart— putting ambitious ideas to work to generate real solutions for real people. From the R&D lab, to the factory floor, to the conference room, every one of us experiments, creates, builds, improves and solves. We have the talent, diverse perspectives, and guts to engineer the extraordinary.