Funding Verification Specialist - Remote

Lingraphica is a mission-driven organization that provides speech-generating devices to help improve communication, speech, and quality of life for people with communication impairments.  We look for candidates who enjoy working in a fast-paced, goal-oriented environment, and who share our commitment to helping individuals on their communication journey.

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).
• Strong data entry, documentation, and organizational skills with a high level of accuracy and attention to detail.
• Methodical approach to gathering information, conducting research, and resolving issues effectively.
• Effective verbal and written communication skills with a professional, customer-focused approach.
• Compassion for individuals with disabilities and the ability to communicate effectively with clients who have speech impairments.
• Ability to build rapport and maintain professionalism when interacting with clients, caregivers, providers, and internal stakeholders.
• Strong critical thinking and problem-solving skills, with the ability to assess risk and make informed decisions.
• Ability to exercise sound independent judgment within established guidelines and appropriately escalate complex or high-risk situations.
• Ability to identify alternative solutions, evaluate options, and recommend appropriate courses of action.
• Demonstrates adaptability in response to changing priorities, processes, and business needs.
• Exhibits innovative thinking and a willingness to explore new approaches to improve outcomes and efficiency.
• Open to giving and receiving feedback, with a commitment to continuous learning and professional growth.
• Ability to manage multiple priorities and maintain consistent performance in a fast-paced, process-driven environment.
• Strong attention to detail while balancing productivity, quality, and timeliness.
• Maintains a sense of urgency and takes ownership of responsibilities through to resolution.
• Proactive, solutions-oriented mindset with the ability to anticipate challenges and address them effectively.
• Demonstrates accountability, follow-through, and ownership of assigned work.
• Takes initiative to identify opportunities for improvement and contribute to team and organizational success.

Education and Experience 

• High School Diploma or GED, required 
• Associate's degree or equivalent combination of education and experience, preferred 
• 3 years of healthcare, insurance, DME, medical billing, benefits verification, or related experience, required
• Experience with Medicare, Medicaid and Commercial insurance, required
• Experience in customer service and/or administrative support, preferred
• Experience with Microsoft Office, TrueSight, Inovalon, or HubSpot, preferred 

Work Environment & Physical Demands 
Work is performed remotely from a home office. The individual is expected to maintain a safe, productive workspace with reliable and secure internet access.  

Travel 
Travel by air is required up to 2 times per year within the US for in-person team meetings and an all-company meeting.   

Accommodations  
To perform this job successfully, an individual must be able to perform each essential duty and physical demand satisfactorily. The requirements listed above are representative of the knowledge, skills, and/or abilities and physical demands required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

If you require an accommodation, please reach out to Human Resources at [email protected] for assistance. We are here to help! 

Lingraphica and Pay Transparency  

At Lingraphica, we are committed to fair and equitable compensation practices. The starting salary range for this position is $50,000 to $55,000 per year. Placement in the starting pay is based on factors such as experience, skills, education, and internal equity. We regularly review our compensation structures to ensure they align with industry standards, promote fairness, and support career growth. In addition to competitive base pay, we offer a comprehensive benefits package and a commitment to fostering an inclusive and supportive workplace. We encourage open conversations about compensation and are dedicated to maintaining transparency throughout the hiring process. 

To learn more about Lingraphica, visit: www.lingraphica.com! To learn more about our benefits offerings, click here!

This Organization Participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. 

Este empleador participa en E-Verify y proporcionará al gobierno federal la información de su Formulario I-9 para confirmar que usted está autorizado para trabajar en los EE. UU.