Coordinator, Reimbursement

Who we are

In a life without sound, our work provides meaning. As a leading provider of innovative hearing care solutions, we are not just a company that makes products: we are a team on a mission to help people enjoy the delight of hearing. To enable a life without limitations, through our core business brands - Advanced Bionics, Audiological Care, Phonak, Sennheiser (under license) and Unitron - we develop, manufacture and distribute solutions that push the limits of technology and redefine the future of our industry.

Valencia, CA - Remote

Coordinator, Reimbursement

The Reimbursement Coordinator provides remote support to assist customers with health care reimbursement needs.

Responsibilities:

• Obtains insurance benefit & eligibility and processes prior approvals for patient orders (accessory, processors and surgeries (both standard & revisions) via web portals, email, fax, and phone with adequate performance. Claim submission to health plan, reconciliation of claims, patient invoicing and refunds.
• Works with cochlear implant clinics, surgery centers, Primary Care Providers and all outside medical facilities to obtain applicable medical records to facilitate insurance process for patient orders.
• Acts as the liaison between the patient, the medical professional and health plan(s) to process positive health plan determinations and claim payment for the insurance reimbursement process.
• Research and responds to customer inquiries regarding insurance orders. Including but not limited to, health plan updates, benefit details, patient responsibility of applicable deductible & coinsurance amounts.
• Timely completion and submission of CMS 1500 claim forms via electronic and paper methods as required by payor(s).
• Timely review and correction of all clearinghouse's related issues and rejects.
• Assists the internal customers (Customer Service, Recipient Upgrades, Shipping, Sales) with patient insurance inquiries and insurance prerequisites for prior approval submissions and claim payment
• First level appeals for all denials or any partially paid claims. Including completion of all required forms and submission of all documents needed to support medical necessity.
• Timely follow-up and aggressive recovery of all money due to Advanced Bionics from health carriers and patients.
• Maintains acceptable quality, collection and follow up levels and determined by department goals.
• Other duties as assigned

Additional Key Responsibilities: Maintain & update patient insurance records as needed. Perform prior approval and claim appeals as needed.

More about you:

Education

• High School Diploma

Work Experience

• Minimum of 2 years of experience in health care reimbursement

Nice to Have

• 2 years of health care insurance reimbursement experience in eligibility & benefit verification prior approvals and claim processing

Language(s)/ Skills

• English

IT Skills

• Microsoft Office

A minimum of 200Mb/sec download and 10Mb/sec upload speed internet connectivity is required to support any remote/hybrid employee functionality at Sonova

Don't meet all the criteria? If you're willing to go allin and learn we'd love to hear from you!

We are looking forward to receiving your application via our online job application platform. For this position only direct applications will be considered. Sonova does not recruit via app, telegram, carrier pigeon or any other format that does not include speaking with an actual human. If you are offered a job without speaking with someone, please contact Sonova Human Resources.

What we offer:

• Medical, dental and vision coverage*
• Health Savings, Health Reimbursement, Flexible Spending/Dependent Care Accounts
• TeleHealth options
• 401k plan with company match*
• Company paid life/ad&d insurance
  
  
  
  • Additional supplemental life/ad&d coverage available
  
  
  
  
• Company paid Short/Long-Term Disability coverage (STD/LTD)
  
  
  
  • STD LTD Buy-ups available
  
  
  
  
• Accident/Hospital Indemnity coverage
• Legal/ID Theft Assistance
• PTO (or sick and vacation time), floating Diversity Day, & paid holidays*
• Paid parental bonding leave
• Employee Assistance Program (24/7 mental health support hotline, 5 company paid counseling sessions and more)
• Robust Internal Career Growth opportunities
• Tuition reimbursement
• Hearing aid discount for employees and family
• Internal social recognition platform

*Plan rules/offerings dependent upon group Company/location.

This role's pay rate is: $27.00/hr, compensation is based on skillset and location. This role is also bonus eligible.

How we work:

At Sonova, we prioritize the well-being of our employees and foster an inclusive environment that promotes engagement and collaboration. Our team-customized hybrid work model empowers teams to balance individual needs with business goals, offering flexibility and individualized time management. We recognize the importance of life outside of work and strive to create a supportive and motivating workplace where innovation thrives.