Insurance Support Services Team Lead

About The Company

MED-EL Corporation is a global leader in hearing implant technology and research. While headquarters resides in Austria, our US branch is based in Durham, North Carolina, at Research Triangle Park. We pride ourselves in being innovators through and through. We bring people the joy of sound through our extensive portfolio of hearing technology and consistently pursue product and process improvement. MED-EL hearing implant systems combine the latest scientific advances, engineering, and manufacturing techniques to offer performance, safety, and reliability.

With people at the epicenter of our research and technology, we relentlessly pursue connection—connection to sound, connection to each other, connection to possibility. Here at MED-EL, we are proud to offer a diverse, team-focused culture driven by our passion to support candidates, recipients, their families, and clinical partners.

Full-Time / Hybrid / Durham, NC

The Insurance Support Services Team Lead will be responsible for overseeing, coaching, training, and managing daily workflow operations. The Insurance Support Services Team Lead will also ensure that we are following industry standards and will provide exceptional customer service to our internal and external customers. They serve as a first line of support for escalated phone calls and elevated customer needs.

• Provide floating coverage within supported regions as daily staffing is required.
• Manage assigned customers/centers/regions, as business needs evolve.
• Support specialty product lines (e.g., ADHEAR) and/or assigned states/customer groups.
• Handle escalations and urgent orders.
• Collaborate closely with supervisors and the team for efficient order processing.
• Provide backup to peers (Team Leads) and supervisors.
• Manage workflow reporting needs daily in collaboration with management to ensure timely order processing.
• Understand and monitor workflows and alert management when workflows do not support optimal and efficient customer support.
• Ensure all team activities comply with relevant regulations and standards, including HIPAA guidelines.
• Conduct regular quality assurance checks and implement improvement practices.
• Conduct ongoing training reviews for existing staff to keep them updated on the latest industry practices and regulations, and to review updated or new processes as needed.
• Work closely with other departments, such as Customer Account Services, and Revenue Cycle, to ensure seamless operations and effective communication.
• Comply with and adhere to all regulatory compliance areas, policies, and procedures and “best practices.”

• Demonstrate alignment with MED-EL values through performance and behavior.
• Familiarity with all medical coding systems (CPT, ICD-10, HCPCS).
• Insurance coverage research experience and work with payers for product coverage.
• Excellent communication skills (verbal, written, and in-person) and customer service skills for internal and external customers.
• Ability to maintain concentration and attention to intricate details for extended periods while sitting at a desk.
• Maintain current extensive knowledge of Medicare/Medicaid and private payer insurance programs as related to authorization of medical services, eligibility and insurance billing and collection related to company products.
• Uphold MED-EL Quality System requirements, detailed operational procedures, and various regulatory requirements relevant for medical device companies, Medicare, and Medicaid Providers.
• Perform under pressure, including time-pressure/deadlines, quality audits and various regulatory (FDA, HIPAA, Medicare, OIG, OCI) inspections, etc.
• Medical preauthorization and appeals experience and familiarity.
• Experience with hearing implant front-end VOBs, authorizations, denials, and appeals.
• Demonstrated professional approach to continued service improvement – when opportunities are noticed, approach the opportunity collaboratively, engaging management as appropriate.
• Demonstrated knowledge of coverage guidelines with major payers in assigned regions; and demonstrated ability to read and interpret coverage…