Funding Verification Specialist - Remote

About this role

Purpose: The Funding Verification Specialist is responsible for verifying insurance benefits, determining appropriate funding and payment options, and assessing case/deal viability to support successful device trials and procurement so that appropriate candidates may trial and procure a Lingraphica device. Essential Duties & Responsibilities: Acquire insurance benefit coverage via phone or online portal Interpret benefit coverage information to determine anticipated costs for clients Use discernment and judgment to evaluate the accuracy, completeness, and reliability of insurance benefit information and identify discrepancies or gaps requiring additional verification Assess case viability by evaluating expected reimbursement, payor requirements, funding criteria, and the likelihood of successful reimbursement prior to initiating a trial.

Determine device trial funding options based on the patient’s insurance coverage Recognize and identify potential coordination of benefits (COB) issues and proactively engage with the patient and/or care partner to gather information and assist in resolving discrepancies. Review benefits for accuracy prior to sale Clearly communicate funding determinations, potential barriers, and recommended next steps clearly to internal teams and, when appropriate, patients and care partners.

Maintain accurate, complete, and compliant documentation of insurance verification, funding determinations, patient records, and related communications in accordance with HIPAA, Medicare, and organizational requirements. Proactively communicate with team members regarding identified potential issues and concerns Maintain patient records according to HIPAA and Medicare guidelines Track and trend issues to aid in the resolution and prevention of repeat problems Complete all administrative functions, such as data entry, associated with sales activities in a timely manner and in accordance with established processes Identify and escalate priority issues and proactively follow up on tasks Perform other duties and special projects as assigned Skills and Competencies: Knowledge of insurance plans, funding sources, and reimbursement processes related to Durable Medical Equipment (DME).