Verification Specialist

Join us today and make a difference in people's lives!

LivaNova is a global medical technology company built on nearly five decades of experience and a relentless commitment to improving the lives of patients around the world. Our advanced technologies and breakthrough treatments provide meaningful solutions for the benefit of patients, healthcare professionals, and healthcare systems. The company is listed on the NASDAQ stock exchange under the ticker symbol " LIVN ." LivaNova is headquartered in London (UK) with a presence in over 100 countries and a team of more than 3,000 employees worldwide.

LivaNova Neuromodulation:

As pioneers of the VNS (Vagus Nerve Stimulation) Therapy system, LivaNova continues to advance medical device solutions for patients affected by Drug-Resistant Epilepsy (DRE) and Difficult-to-Treat Depression (DTD). There are 3 million people in the U.S. alone and one on three people with epilepsy are drug resistant. People with severe seizures have, on average, a shorter life expectancy and an increased risk of cognitive impairment particularly if the seizures developed in early childhood. VNS Therapy for DRE is delivered through a device that sends mild pulses to the vagus nerve at regular intervals throughout the day in an effort to prevent seizures.

Job Profile:

The Verification Specialist is responsible for receiving and processing faxed patient information submitted to LivaNova Case Management and for verifying patient benefits for VNS. This position creates the patient record in LivaNova's Customer Relationship Management (CRM) system, collects patient information regarding benefits, prior authorizations and predeterminations then coordinates flow of such information. This role also provides support to providers regarding VNS Therapy reimbursement by verifying whether patients are eligible for benefits. The Verification Specialist is a member of the Case Management organization and reports to a Verification Specialist Supervisor who reports to a Case Management Manager.

PRIMARY ACTIVITIES:

Verification Specialist- Administration

• Manages receipt and data entry of all incoming faxes including PIQs/MDFs and patient medical records in a timely manner

• Creates new patients and opportunities in LivaNova's CRM as needed when new PIQ /MDF arrives, then saves related documents into SharePoint

• Verifies completeness of patient and opportunity information within Customer Relationship Management system, when requested

• Confirms Implant Warranty Forms and enters information into the CRM system

• Creates update note within the CRM system when faxed information is received and notifies Case Manager via email of the documents received, attaching the document to the email

• Manages scanning and electronic storage of incoming hard copy correspondence

• Performs self-assessment of all activities to ensure accuracy

Verification Specialist- Insurance

• Verifies completeness of patient and opportunity information within the CRM system

• Completes insurance verifications (eligibility, benefits, referrals, and prior authorization) on behalf of the healthcare provider within 24-48-hour turn-around period

• Assists with identification of VNS Therapy policies with payers in the area of responsibility

• Assists Case Management department with specific tasks as requested

• Assist Case Management with payer data collection

• Gather Verifications FAQS, responsible to send information to VS IV Supervisor for updates as needed

• Communicates with payor/health care plan for status update of previously submitted authorization requests, when requested

• Determines when prior authorization will be required by payors. Will identify route of submission (telephonic, fax, Availity or health plan portal)

• Identifies in-network or out-of-network physician/facility status and relays information to territory CM/PACM

• Identifies new payers, gather pertinent information and submit to VS-IV Supervisor for CRM system updates

• Communicates closely with territory case managers and prior authorization case managers

• Any duties as assigned by the VS-IV Supervisor or Case Manager, Manager

• Will attend morning strategy meetings as assigned

ADDITIONAL ACTIVITIES

• Performs other duties as require by management

• Maintain current training as required by LivaNova and Case Management

• Attend meetings/conferences relating to and providing updates as needed

MINIMUM REQUIREMENTS AND QUALIFICATIONS FOR ALL LEVELS

• High school diploma or equivalent

• Good organizational skills with attention to detail

• Good telephone etiquette

• Familiarity with Word, Excel, PowerPoint, Microsoft Outlook programs

• Coding/Billing software experience or relevant experience is highly encouraged

• Previous experience in office and/or hospital coding and billing, prior authorization experience at the office or hospital setting or relevant experience

• Knowledge of health insurance industry practices/functions

• Strong work ethic

• High level of integrity and tact

• The minimum requirements, skills and qualifications contained in this job description outline the core function and requirements of the position ad do not constitute an exhaustive listing of activities, duties, or responsibilities that may be required of or assigned to an employee in this position at the Company's discretion. Further, the ability to meet the minimum requirements and/or possession of the stated skills and qualifications do not imply or establish that an individual will be employed in this position.

ADDITIONAL QUALIFICATIONS

• Verification Specialist I

  • Entry level and meets the minimum requirements for employment.

• Verification Specialist II:

  • Meets Support Specialists requirements and is able to perform the duties of Verification Specialist I.

  • Knowledge of ICD-10 and CPT 10 coding, and medical terminology.

  • Minimum of 5 years' experience as a Verification Specialist I

• Verification Specialist III:

  • Meets Verification Specialist I and II requirements and can perform the duties of Level 2 at a high level.

  • Demonstrates skill in coaching/leading others.

  • Minimum of 10 years' experience as a Verification Specialist

Pay Transparency: A reasonable estimate of the hourly rate for this position is $25 - $35 per hour. Pay ranges may vary by location.

Employee benefits include:

* Health benefits - Medical, Dental, Vision

* Personal and Vacation Time

* Retirement & Savings Plan (401K)

* Employee Stock Purchase Plan

* Training & Education Assistance

* Bonus Referral Program

* Service Awards

* Employee Recognition Program

* Flexible Work Schedules

Valuing different backgrounds:

LivaNova values equality and diversity. We are committed to ensuring that our recruitment process is fair, transparent and free from unlawful discrimination. Our selection process is driven by the key demands/requirements for the role rather than bias or discrimination on the basis of a candidate's sex, gender identity, age, marital status, veteran status, non-job-related disability/handicap or medical condition, family status, sexual orientation, religion, color, ethnicity, race or any other legally protected classification.

Notice to third party agencies:

Please note that we do not accept unsolicited resumes from recruiters or employment agencies. In the absence of a signed Recruitment Services Agreement, we will not consider, or agree to, payment of any referral compensation or recruiter fee. In the event that a recruiter or agency submits a resume or candidate without a previously signed agreement, we explicitly reserve the right to pursue and hire those candidate(s) without any financial obligation to the recruiter or agency.

Beware of Job Scams:

Please beware of potentially fraudulent job postings or suspicious recruiting activity by persons posing as LivaNova recruiters or employees. The scammers may attempt to solicit confidential, personal information, such as a social security number, or your financial information. LivaNova will never ask for fees prior/during/after the application process, nor will we ask for banking details or personal financial information in return for the assurance of employment. If you are concerned that an offer of employment might be a scam or that the recruiter is not legitimate, please verify by searching for "See Open Jobs" on https://www.livanova.com/en-us/careers, and check that all recruitment emails come from an @livanova.com email address.