Medical Authorization Specialist (Finance)
Are you ready to work for a more active world?
At Bioventus, our business depends on developing our people. We invest in you and challenge you to be the best. We value our colleagues for their different perspectives and individual contributions, and our leaders listen. Our success rests on working together to achieve shared goals and rewards. Join a diverse team of global colleagues driven to help patients resume and enjoy active lives.
As a Medical Authorization Specialist (MAS) you will support the reimbursement strategy of the company by aggressively pursuing authorization and reimbursement while establishing a resource of expertise to the payers. You will need to demonstrate, through actions, a consistent performance standard of excellence to which all work is to conform.
1. Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans.
2. Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company's products.
3. Submits pertinent demographic and supporting clinical documentation with pre-authorization requests timely to avoid unnecessary delays in patient treatment.
4. Maintains and documents complete, timely, and accurate patient insurance and billing information.
5. Performs on-going check and balance system to ensure the integrity of the patient billing data.
6. Operates compliantly at all times by keeping patient data secure and confidential and adhering to all company policies and procedures.
7. Works with the Order Management team to secure any additional information and medical documentation from the patient and/or prescribing HCP.
8. Complies with all health, safety and environmental policies, procedures and job hazard analyses applicable to specified job activities; including medical evaluations as required by job function.
9. Completes all required training in a satisfactory and timely manner.
10. Holds oneself and others accountable to conduct business in a manner compliant with Bioventus' Code of Compliance, policies and procedures and internal controls applicable to their role.
11. Other duties as assigned
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Bioventus is committed to fostering an inclusive and diverse community of employees with a strong sense of belonging. We believe we are bettered by all forms of diversity and take pride in working with top talent from every walk of life. In the spirit of inclusivity, qualified applicants will be considered without regard to age, ethnicity, disability, gender, veteran status, gender expression, gender identity, nationality, race, religion or sexual orientation. All individuals, regardless of personal characteristics, are encouraged to apply.
