Medicare Specialist

Tactilemedical; Minneapolis (MN); On-site; USD 33,000 - 43,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Job summary

Tactile Medical specializes in at-home therapy devices for lymphedema, chronic venous insufficiency, and respiratory illnesses. The Medicare Specialist ensures Medicare criteria are met for claim submissions and drives documentation to closure.

Responsibilities include coordinating with clinicians, patients, and internal teams, maintaining service levels, and contributing to process improvements while upholding HIPAA standards.

Qualifications

• Bachelor’s degree or equivalent work experience.
• 2+ years of experience in medical device or health care reimbursement.

Responsibilities

• Review medical records and documentation for Medicare medical necessity.
• Serve as liaison between the company, clinicians, healthcare teams, and patients to obtain necessary paperwork.
• Collaborate with internal departments to ensure successful Medicare submissions.
• Maintain and/or exceed department service levels including turnaround time.
• Assist team members and participate in training of new staff.
• Maintain compliance with regulatory requirements including HIPAA.

Skills

Medicare methodologies

Regulatory/compliance

Communication skills

Multi-tasking

Relationship building

Team collaboration

Problem solving

Education

Bachelor’s degree or equivalent

Tools

Microsoft Word

Excel

Teams

Outlook

Job description

At Tactile Medical, we specialize in developing at-home therapy devices to treat lymphedema, chronic venous insufficiency and respiratory illnesses.

The Medicare Specialist is responsible for ensuring Medicare criteria is met for claim submissions.

Accountabilities & Responsibilities:

• Review medical records and checklist documentation for specific criteria to satisfy Medicare’s medical necessity requirements
• Serve as an expeditor/liaison between Tactile Medical, clinicians, healthcare teams, and patients to obtain all necessary paperwork to drive order to closure
• Collaborate with pertinent internal departments to ensure successful Medicare submissions
• Maintain and/or exceed department service levels including turnaround time
• Be a team player. Assist other team members when needed
• Be a champion for continuous process improvement. Ask questions and continually look for ways to make processes better, faster or more efficient
• Contribute to monthly 1:1, small and large group team meetings
• Participate in training of new team members or field reps, handle product conversions and/or general account support
• Maintain compliance with all regulatory requirements including HIPAA
• Other duties as assigned

Education & Experience Required:

• Bachelor’s degree or equivalent work experience
• 2+ years of experience in medical device or health care reimbursement

Preferred:

• Previous experience with third-party payer regulations and processes, with emphasis on Medicare

Knowledge & Skills:

• Understanding of Medicare methodologies (coding, coverage, clinical criteria, payment)
• Proficiency working with Microsoft Word, Excel, Teams and Outlook with the ability to navigate multiple systems
• Strong aptitude for learning systems and understanding processes quickly
• Exhibit excellent grammar, verbal and written communication skills
• Strong critical thinking skills
• Proven track record of building effective relationships with stakeholders
• Strong collaborative style, both internally and externally, to ensure objectives are met
• Results driven and proactive
• Thrives in a team environment but is also self sufficient
• Strong ability to multi-task and prioritize
• Passionate and eager to learn new skills
• Ability to adapt to an ever-changing environment
• Receptiveness to feedback
• Consistent follow up skills

Competencies:

• Organization
• Teamwork
• Action Oriented
• Communication
• Documentation
• Process Management
• Priority Setting
• Peer Relationships
• Problem Solving

Our total compensation package includes medical, dental and vision benefits, retirement benefits, employee stock purchase plan, paid time off, parental leave, family medical leave, volunteer time off and additional leave programs, life insurance, disability coverage, and other life and work wellness benefits and discounts. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.

Below is the starting salary or hourly range for this position, although offers may differ based on the candidate's location, job-specific knowledge, skills and experience.

US Pay Range

$23.89 — $31.35 USD

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