Reimbursement and Market Access Specialist
Reimbursement and Market Access Specialist
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Job Description
What you will do:
As our Reimbursement and Market Access Specialist you will provide reimbursement expertise and support to both internal and external customers regarding all phases of the reimbursement procedures and related patient access activities to achieve the objective of successfully assisting procedures through the billing reimbursement and appeals process.
Supports the daytoday reimbursement inquiries from the field sales and external physician ASC and hospital providers and customers for IVS products.
Communicates reimbursement updates to customers as needed.
Conducts basic research on reimbursement codes and policies including CPT HCPCS ICD9 & ICD10 and payer guidelines.
Answers and responds accurately and timely to questions on the telephone voicemail email Coding Hotline and/or Coding email box as appropriate.
Collaborate with customers to research troubleshoot and resolve claim issues and reimbursement challenges.
Provides support in the prior authorization denial and appeals process to providers clinical office staff and salesforce.
Communicates with clinical and office staff providers and salesforce regarding any missing incomplete or inconsistent documentation and to obtain accurate billing codes as necessary.
Assist with the deployment of payer and provider focused communications regarding the value of Stryker IVS products
Manage all aspects of the Coding Hotline and Email contacts responding to inquiries as needed track and trend data related to contacts reporting information.
Accurately follows Stryker HIPAA policies guidelines and legal requirements to ensure compliance.
May develop reimbursement tools and analytics to support the organizations strategic objectives and operational goals.
Requires additional development and training to advance to Senior Specialist.
What you need:
Required:
Bachelors degree or Associates degree plus 4 years of relevant work experience or 6 years of relevant work experience
Preferred:
Experience in providing coding coverage and payment advice in a healthcare setting
Experience with prior authorization denials and appeals process
Knowledge ofcoding guidelines medical procedures and services to appropriately review OP reports/notes rejected claims and EOBs
Knowledge of Medicare Medicare Advantage Medigap and private/commercial payer methodologies
Licensure or Certification: CPC (Certified Professional Coder through American Academy of Professional Coders) or CCSP (Certified Coding Specialist Physician based through American Health Information Management Association)
$58700 $106200 salary plus bonus eligible benefits. Actual minimum and maximum may vary based on pay is based on skills experience and other relevant factors.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
