.Who We Are- Iconic brands. Global locations. Extraordinary people. These elements, infused with our commitment to continuous improvement, set us apart from the competition and create a career and customer experience like no other. As a diversified technology company, we have leading positions in orthopedic solutions, industrial welding and cutting, and specialty gas regulation and control. Our products and services help improve the lives of our customers around the world. And, with over 15,000 passionate associates in offices across six continents, we advance our positive impact every day on a worldwide scale.- If you're craving an opportunity to shape a growing global company, work with highly-motivated colleagues and make a difference right away' then Enovis Corporation (NYSE: ENOV) is the place for you. Check out our current career opportunities today!- What You'll Do- The Patient Care Service (PCS) Representative II seeks benefit coverage for patients from insurance groups with the responsibility of timely and compliant order entry, benefit verification and prompt follow up. This position works collaboratively with cross-functional internal and external teams to obtain necessary documentation required to obtain insurance authorizations.- JOB RESPONSIBILITIES- Answers inbound and outbound calls, researches, and identifies insurance to ensure compliant/proper account resolution.- Verifies insurance eligibility and follows coordination of benefits guidelines.- Faxes accurate and thorough Pre-Authorization Request Letters.- Determines revenue amounts based on allowable, benefits, unit price, payer guidelines, copayment and contract pricing.- Submits appropriate and accurate billing to Government entities and private insurance payers consistent with Federal, State and insurance-specific requirements.- Pursues supporting documentation from Sales Team to ensure all required documents are received prior to invoicing.- Reviews prescriptions, Letters of Medical Necessity and/or Chart Notes to ensure both completeness and accuracy.- Ensures that orders meet criteria and compliance standards, and resolves assigned denials and variances by accurately determining the root cause and collaborating to reduce the denial or variance.- Works to resolve submission issues which can include obtaining the appropriate Medical Record documentation or validation of coding.- Reviews orders for accuracy and completeness prior to providing the "OK to Place" and invoicing.- Processes assigned correspondence and telephone inquiries from patients and payers in a compliant manner and promptly responds in writing or verbally.- Appropriately challenges insurance companies by communicating information on Medical Necessity and negotiating coverage and pricing for the purchase of DJO products that meet all applicable payor guidelines.- Serves as back-up for other PCS Representatives and their assigned region(s), as needed, to maintain timely turnaround time (TAT)