Clinical Compliance Reviewer

Why join us?

We're on a mission to empower people with disabilities to do what they once did or never thought possible. As the world-leader in assistive communication solutions, we empower our customers to express themselves, connect with the world, and live richer lives.

At Tobii Dynavox, you can grow your career within a dynamic, global company that has a clear, impactful purpose - with the flexibility to also do what truly matters to you outside of work. What's more, you'll be part of a work culture where collaboration is the norm and individuality is welcomed.

As a member of our team, you'll have the power to make it happen. You'll solve challenges, deliver solutions and develop new, efficient processes that make a direct impact on our customers' lives.

What you'll do:

The Clinical Reviewer is responsible to ensure healthcare documents are following the insurance companies' guidelines. This individual works closely with SLPs, TD sales representatives, families, government agencies, and educational institutions to obtain healthcare documents that are compliant and thoroughly reviews documents for submission ensuring they meet third party payer criteria.

As an Clinical Compliance Reviewer, you will be responsible for:

• Maintain communication with SLPs on funding cases by phone, email and teams and instruct SLPs on document preparation and funding policies and regulations
• Work with insurance providers, government agencies, and educational institutions to ensure guidelines are met for these entities.
• Be an expert in the Efunding tool to be able to assist SLPS, families and solution consultants with completion of a funding packet.
• Help ensure the success of Efunding tool.
• Utilize on-line resources and maintain current insurance requirements.
• Review prior authorization documents against third party payer criteria
• Research previous orders and payment history.
• Serve as a client advocate by communicating with clients and family members on funding requests, representing client's case with third party insurance providers and troubleshooting any problems to resolution
• Ensure our speech evaluation templates are always current and meet industry standards
• Create new speech evaluation templates as requirements change.
• Alert supervisor of potential third party payer challenges
• Work closely with learning team/funding coaches.
• Assist Funding team with resources
• Attend additional training resources as assigned including but not limited to SLP trainings, Funding dept trainings, insurance trainings.
• Perform various other duties as assigned, including but not limited to, helping with cases, placing/funding orders, eligibilities.

Minimum Qualifications

• Bachelor Degree, or 2 - 4 years related experience
• Background in the health insurance field preferred
• Internet navigation skills
• MS Office Word and Outlook

What you'll bring:

• Oral and written communication skills
• Interpersonal, collaboration, and teaming skills
• Customer service orientation
• Able to multi task in a fast paced environment

E. WORK ENVIRONMENT REQUIREMENT:

• Able to work at a desk for prolonged periods of time
• Ability to work with interruptions in a fast paced environment

Apply today!

We believe in empowering individuals - including our own employees - to reach their full potential. So, if you want to change lives while growing your own career, we'd love to hear from you.