Medicare Specialist

Tactile Medical; Minneapolis (MN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

Retirement benefits

Employee stock purchase plan

Paid time off

Parental leave

Family medical leave

Volunteer time off

Life insurance

Disability coverage

Job summary

Tactile Medical, a provider of at-home therapy devices, seeks a Medicare Specialist in Minneapolis to ensure Medicare criteria are met for claim submissions. The role involves expediting paperwork between clinicians, patients, and internal teams to drive orders to closure, while maintaining HIPAA compliance and high service levels.

Ideal candidates have a bachelor’s degree (or equivalent) and 2+ years in medical device reimbursement, with strong communication, multitasking, and

Qualifications

• Understanding of Medicare methodologies (coding, coverage, criteria, payment).
• Experience with medical device reimbursement and payer processes.
• Ability to navigate multiple systems and maintain documentation.

Responsibilities

• Review medical records and criteria to satisfy Medicare medical necessity.
• Expedite/liaise between Tactile Medical, clinicians, and patients to obtain paperwork.
• Collaborate with internal departments to ensure Medicare submissions.
• Maintain or exceed department service levels including turnaround time.
• Be a team player and assist others as needed.
• Champion continuous process improvement and seek efficiency gains.
• Contribute to monthly team meetings and 1:1s.
• Train new staff and handle product conversions and account support.
• Maintain HIPAA compliance and perform other duties as assigned.

Skills

Medicare knowledge

Reimbursement processes

Microsoft Word

Excel

Teams

Outlook

Communication

Multitasking

Relationship building

Process improvement

HIPAA compliance

Education

Bachelor’s degree or equivalent work experience

2+ years of medical device/health care reimbursement experience

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
• 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.

As set forth in Tactile Medical’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

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