Reimbursement Representative

Company: Audtalent

General Information
US-NJ-Franklin Township
Not Specified
At least 2 year(s)
Not Specified
Job Description

Company Overview:

Oticon Medical is a global company in implantable hearing solutions, dedicated to the vision of making life changing difference to people living with hearing loss (this is the official vision). We are part of the William Demant Group - one of the world’s largest groups of hearing health care companies with more than 11,000 employees worldwide and revenues of over $1.6B. We share a close link with Oticon hearing aid operations and have direct access to the latest advancements in hearing research and technologies. Our competencies span more than a century of innovations in sound processing and decades of pioneering experience in hearing implant technology. By working collaboratively with patients, physicians, and hearing care professionals, we ensure that every solution we create is designed with user needs in mind. We share an unwavering commitment to provide innovative solutions and support that enhance quality of life for people wherever life may take them. Because we know how much sound matters!

Oticon Medical is a global leader of bone anchored hearing aids and is one of the fastest growing companies in the medical device market. The team is knowledgeable and energized and is proud to employ members of the world’s leading pioneers in osseointegration. This expertise and attitude has positioned Oticon Medical with superior quality products, enormous know-how and solid access to the market through direct organizations, wholesalers and distributors.

The US market is one of the top priorities for Oticon Medical due to the size and the attentiveness for new technology and related support services. With the BAHS segment Oticon Medical has solid market position, but we expect that the company is able to further build share with the newly introduced Ponto 3 sound processor. We are also preparing FDA submission for our Cochlear Implant.

Oticon Medical will continue their market expansion, but more importantly continue the development of a new range of innovative implants, tools and support services to surgeons and audiologists.

Postion Description:

The primary purpose of the Reimbursement Representative position is to process product orders and oversee the entire process of insurance billing and payment for all our customers, while striving to improve the communication between customers and the Oticon Medical LLC. The position will also be responsible for insurance benefit pre-determinations and pre-approvals.


  • Phone and email contact with patients, customers and colleagues relative to billing and payment related reimbursement questions
  • Insurance billing
  • Accurate and timely billing
  • Medicare: replacement processors, repairs and batteries
  • Medicaid: sound processors on soft bands, replacement processors, repairs and batteries
  • Collect and process patient out of pocket payments
  • Monitor all claims payment via review of Explanation of Payment or other documents
  • Investigate payment denials and work with Finance Dept. and Director of Reimbursement as needed to reverse denials and ensure accurate/expected payment is received
  • Order placement
  • Maintain billing software – responsible for making updates to fee schedules and expanding use to all payer types
  • Ensure all files in the Somerset office are in order as per processes outline in manuals
  • Work with the Director of Reimbursement to ensure that policies and procedures are in place to meet current standards and that they are being followed
  • Potential to grow as we expand our business into the Cochlear Implant market as well.
  • Qualifications:
  • Demonstrably strong knowledge and experience with medical reimbursement, eligibility and benefits and prior authorization.
  • Self-starter and collaborative team player; self-motivated with high level of energy, ability to work with limited supervision and demonstrate business maturity in areas of decision-making and conflict resolution
  • Strict attention to detail; work well under pressure while meeting tight deadlines
  • Customer service oriented
  • Critical thinker with superior problem solving skills
  • Excellent verbal and written communication skills.
  • Computer literacy: Microsoft Office Suite
  • Education And/Or Experience

    Minimal of two years’ experience with DME billing (experience with Brightree a plus) and knowledge of coding systems (CPT, HCPCS, ICD-9 and ICD-10). Excellent typing and computer skills. Knowledge of Excel, Word, SharePoint, and (Brightree, Navision are preferred). Knowledge of billing rules and regulations – in particular Medicare Supplier Regulations. Must be able to demonstrate superior customer oriented attitude and pleasant personality, ability to self-direct and familiarity with fee schedules. Prior experience with insurance benefit determinations and pre-authorizations preferred.

    Oticon Medical is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.


    Job Requirements