Authorizations Representative

Job Description

Job Description

Description : The Opportunity

H-Wave is looking for a motivated and skilled Authorizations Representative to join our operations team. The ideal candidate will be a strong communicator, detail-oriented, and thrive in a collaborative environment. A day in the life of an H-Wave Authorizations Representative consists of seeking and obtaining authorization for patient demonstrations while educating, building relationships, and influencing insurance adjusters and nurse case managers. This is achieved by being proactive, thinking ahead, and reacting quickly with sound decision-making ability.

The Company

H-Wave is the very best in drug-free pain relief and rehabilitation! Our team puts patient outcomes above all else, we treat customers and co-workers like family, and we’re passionate and “all-in” for what we get to do every day.

For over 40 years the H-Wave electronic stimulation device has been used to reduce medication usage, manage pain, and speed recovery from surgery or injury. We provide physicians in the worker's compensation, auto insurance, and personal injury markets with a more effective drug-free alternative, which helps their patients live a better life and improves the efficiency and success of physician offices with more satisfied patients.

When you join H-Wave, you become part of a tight-knit team dedicated to helping people live better lives while also supporting physicians in delivering top-tier care.

The Job

• Through the pre-authorization phase educate Claims Adjusters and Nurse Case Managers throughout the pre-authorization phase, on the benefits and programs associated with the H-Wave.
• Review incoming claim correspondence and ensure appropriate action steps are taken when response is needed.
• Contact insurance adjusters and nurse case managers (payors) to request authorization for patient demonstrations.
• Identify proactive approaches to determine patient eligibility, including patient advocation and patient or attorney contact.
• Regularly and timely follow ups with payors regarding authorization decisions.
• Review and identify utilization review approvals, denials and modifications and ensure appropriate next action steps are taken.
• Develops and cultivates strong relationships, both internally and externally.
• Maintain up-to-date knowledge of state labor codes and guidelines including Laws governing collection efforts for durable medical equipment (H-Wave) and continuing education workshops to gain more skills yearly.
• Delivers excellent customer service and meets the needs of all our customers while executing high-volume calls.

The Benefits

Requirements : Requirements