Purpose: The Funding Verification Specialist is responsible for assessing and determining payment options, while also evaluating business viability, so that appropriate candidates may trial and procure a Lingraphica device.
Essential Duties & Responsibilities:
- Acquires insurance benefit coverage via phone or online portal
- Interprets benefit coverage information to determine anticipated costs for clients
- Uses discernment and judgment to verify the quality of the information provided by insurance companies
- Assess business viability of each case by evaluating expected reimbursement, payer requirements, and overall likelihood of successful conversion prior to trial
- Determines device trial funding options based on the patient’s insurance coverage
- Recognize and identify potential coordination of benefits (COB) issues and proactively engage with the patient and/or care partner to gather information and resolve discrepancies.
- Reviews benefits for accuracy prior to sale
- Clearly communicates funding options in our CRM and to other Lingraphica staff
- Maintains accurate and complete documentation of all inquiries
- Proactively communicates with team members regarding identified potential issues and concerns
- Maintains patient records according to HIPAA and Medicare guidelines
- Tracks and trends issues to aid the team in resolution and prevention of repeat problems
- Completes all administrative functions, such as data entry, associated with sales activities in a timely manner and in accordance with established processes
- Identifies and escalates priority issues and proactively follows up on tasks
- Performs other duties and special projects as assigned