Veterans Administration Specialist

CMS
At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.

ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed to deliver better insights and better outcomes. On any given day, clinicians utilize these ZOLL products for tens of thousands of cardiac patients around the world:

- LifeVest, the world's first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death.

- HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent.

- TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20+ years ago to reduce infarct size in patients with the most severe heart attacks.

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.

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.

Work Shift - Monday - Friday - 10:30 AM - 7:00 PM EST

Job Summary
The VA Specialist is an integral member of the reimbursement team and has primary responsibility for the timely handling of new medical orders from Veterans Administration Medical Centers, hospitals and physician offices. This individual is responsible for front-end functions of the order fulfillment process as well as order processing. Individual will work with Veterans Administrations Medical Centers, Hospitals, and outpatient physician offices in reviewing medical orders and clinical documentation to determine benefit and clinical eligibility for the LifeVest. Individual is responsible for creating and maintaining relationships with Veteran Administration Medical Centers, sales reps, and other internal departments.

Essential Functions

- Creation of patient record

- Verification of benefits

- Obtain necessary documentation (medical order, clinical notes, testing) when appropriate

- Identify qualifying diagnosis based on payer requirements

- Contact National Notification line or local VA Medical Centers to confirm authorizations

- Communicate Purchase Order requirements to sales field

- Obtain initial & reoccurring purchase orders from VA Medical Centers

- Work resolve, and confirm intake orders

- Process Credit Cards for purchase orders issued by the VA Medical Center

- Complete Change of Benefits as needed from 3rd party payers to VAMC payer or VAMC payer to Other Health Insurance when applicable

- Execute timely follow up on all assigned tasks

- Review and complete assigned fax documents for timely credit card processing

- Maintain a score of at least Meets Expectations on monthly scorecard

- Contact customers, VA Medical Centers, and sales representatives to relay and/or obtain insurance information and/or additional documentation to assist with seeking reimbursement and coordination of benefits

- Work closely with Coordination of Patient administration and Territory Managers

Required/Preferred Education and Experience

- High School Diploma or equivalent required

- Associate's Degree in nursing, business, or other related field preferred

- Bachelor's Degree in nursing, business, or other related field preferred

- 1+ year working with the Veterans Administration preferred

- 3+ Years’ experience in the following: insurance verification and end to end processing of an order including billing of the account required