Insurance Verification Specialist

Coloplast Business Centre in San José, Costa Rica is a proud member of the Global Business Centre, supporting Coloplast’s North American operations. We work closely with our colleagues in Szczecin, Poland, home to one of Coloplast’s largest and fastest-growing sites, with around 800 talented professionals. Together, we drive excellence across key business functions—creating a strong, collaborative foundation for Coloplast’s global success

About the job

The Insurance Verification Specialist is responsible for determining patient’s primary, secondary and tertiary insurance payer; verify patients’ benefits, eligibility, and seek authorization for services by contacting insurance companies; determine patient financial impact, if any, and inform them of any possible financial responsibility.

Key Responsibilities:

• Responsible for the timely verification of medical insurance benefits for new patients, existing patients with changes in insurance, and reactivated patients.
• Review and update patient accounts with insurance policy information and process requests accurately.
• Notate each account with a clear summary of patient eligibility and insurance benefits received from the carrier.
• Call government funded and commercial insurance companies to obtain prior authorizations or referrals.
• Determine the correct Coordination of Benefits.
• Complete verification requests confirming the correct network status through the company’s contracts with insurance payers to determine member benefit coverage.
• Ensure all insurance, demographic and eligibility information is obtained, and entered in the system in an accurate manner.
• Responsible for reviewing customer files for missing insurance information required to bill for services rendered.
• Perform financial review on existing accounts to identify benefit issues.
• Assist in maintaining inbound faxes, manuals, logs, and other documentation as required.
• Complete insurance verification and summary of reimbursement, and liability forms.
• Advise the Manager of verification trends and updates.
• Meets individual, departmental, and company goals.
• Other duties as assigned.
• Occasionally, employees currently recognized as high performers through recent performance evaluations, or employees with current demonstrated productivity leadership compared to other employees on existing metrics may be asked to engage in overtime.

Requirements:

•             High school diploma

•             Medical terminology

•             Two years’ experience in medical insurance plans or benefit verification practices

•             Excellent written and verbal communication skills

•             Ability to read and understand explanations of medical benefits.

• We offer:

• Onsite work from our office in San Pedro.
• Challenging tasks and growth opportunities
• International work environment with Scandinavian culture
• Fantastic work atmosphere full of respect and partnership
• Opportunity to use and develop foreign languages in daily work
• Private medical care & Life insurance
• Birthday day off
• Christmas Party & Christmas Box
• Marriage Celebration days
• Asociación Solidarista

Recruitment details

• Please apply online with your CV in English
• We will review all applications continuously and invite selected candidates further to the recruitment process. We will close the offer down once we find the best match for the role.

Thank you!

Pursuing an ambitious growth agenda, Coloplast develops and markets products and services that make life easier for people with intimate healthcare needs. Employing about 16.000 people and with products available in more than 143 countries, we are one of the world´s leading medical device companies. We are constantly growing our business and always looking for new ways to move forward – we explore, learn and look for new ways of doing things.

Coloplast is committed to being an inclusive organization, where people bring their differences to work each day, fulfil their potential and have a strong sense of belonging because – and not despite – of their differences. We therefore encourage all qualified candidates to apply regardless of gender, age, race, nationality, ethnicity, sexual orientation, religious belief or physical ability.

Visit us on Coloplast.com .

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