Novocure

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Clinical Appeals Specialist * Two Positions*

at Novocure

Posted: 6/30/2019
Job Status: Full Time
Job Reference #: 1108695
Keywords: clinical

Job Description

  • Finance/Legal
  • Portsmouth, NH, USA
  • Salary
  • Full Time

The Clinical Appeals Specialist is responsible for advocating overturning all medical necessity denials through payer-specific appeal processes to minimize the financial burden for patients. These positions will build and manage relationships with external and internal partners and will collaborate with and support the other Revenue Operations functional teams.

 

This is a full-time, exempt position reporting to the Manager of Case Management and is based in Portsmouth, NH.

 

Essential Duties & Responsibilities:   

       Understand and navigate government and commercial medical necessity appeal processes

       Draft clinical summaries and appeal letters

       Successfully overturn appeals by problem solving and creative thinking

       Perform clinical chart reviews and provide feedback

       Support internal and external audits as necessary

       Review and prioritize insurance follow-up on accounts in a timely manner

       Assist with documentation preparation for teleconference appeal hearings

       Establish and maintain positive working relationships with internal and external partners

       Work on any projects assigned to the team as necessary

       All other duties or priorities assigned by management as needed

 

Qualifications:

       2-5 years in a medical device or DME company and/or clinical background

       Bachelor's degree or equivalent experience

       Strong knowledge of government and commercial appeals process preferred

       Familiarity with the medical and oncology regulatory environments preferred

       Familiarity with medical terminology, specific to oncology preferred

       Experience with Microsoft Office and SAP preferred

 

Knowledge, Skills and Behaviors:

       Excellent written and verbal communication skills

       Demonstrated excellence in meeting and exceeding customer expectations

       Effectiveness in de-escalating and resolving difficult situations

       Ability to solve problems and set priorities

       Ability to work independently with minimal supervision

       Ability to work cooperatively in a fast-paced office setting

Working Condition:

       Ability to lift 20 pounds

 

 

About Novocure

Our vision

Patient-forward: aspiring to make a difference in cancer.

 

Our patient-forward mission

Together with our patients, we strive to extend survival in some of the most aggressive forms of cancer by developing and commercializing our innovative therapy.

 

Our patient-forward values

innovation

focus

drive

courage

trust

empathy

 

 

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