Reimbursement Specialist

Socket.dev; Minneapolis (MN); On-site; USD 33,000 - 44,000; Full time

Job summary

Tactile Medical is seeking a Reimbursement Specialist to collaborate with patients, clinicians, payers, and internal teams to gather information and documentation to facilitate authorization and reauthorization of equipment. The role requires HIPAA compliance and close coordination with payers to ensure timely payments.

The ideal candidate will have a bachelor’s degree or equivalent, 3+ years in medical insurance or billing, and 2+ years of patient interaction in healthcare or medical device

Qualifications

• Bachelor’s degree or equivalent work experience is required.
• 3+ years of experience working within medical insurance or billing.
• 2+ years of out and inbound patient interaction experience within the healthcare or medical device industry.

Responsibilities

• Assist internal and field team, payers, and patients in understanding payer methodologies and resolution of issues in the order process through outreach and response to inquiries.
• Facilitate Change of Insurance (COI) reviews, outreach, and order movement.
• Obtain information and documentation necessary for authorization or continued authorization requests.
• Serve as a resource for internal team and patients to ensure documentation for reauthorization requests.
• Submit authorization and reauthorization requests and educate payers to secure payment.
• Submit for additional garment orders.
• Other duties as assigned.

Skills

Medical insurance basics

Authorization processes

Patient interaction

Policy knowledge

Education

Bachelor’s degree or equivalent

Job description

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

The Reimbursement Specialist is responsible for collaborating with patients, clinicians, payers, and the internal and field team to retrieve and provide information and documentation necessary to facilitate order movement, authorization or continued authorization of Tactile Medical equipment. Perform all job responsibilities while maintaining compliance with all appropriate regulatory requirements including HIPAA.

Accountabilities & Responsibilities

• Assist internal and field team, payers, and patients in understanding payer methodologies and resolution of issues in the order process through outreach and response to inquiries
• Facilitate Change of Insurance (COI) reviews, outreach, and order movement
• Obtain information and documentation necessary for authorization or continued authorization requests
• Serve as a resource for internal team and patients to ensure we are gathering appropriate documentation for reauthorization requests
• Submit authorization and reauthorization requests and effectively educate payers to secure and ensure appropriate payment
• Submit for additional garment orders
• Other duties as assigned

Education & Experience

Required:

• Bachelor’s degree or equivalent work experience
• 3+ years of experience working within medical insurance or billing
• 2+ years of out and inbound patient interaction experience within the healthcare or medical device industry

Preferred:

• Previous experience with prior authorizations
• Experience with outpatient DME billing (rental products)

Knowledge & Skills

• Strong knowledge of medical insurance benefits and authorization processes
• Must be persuasive and credible with third party payers
• Demonstrated organizational and time management skills
• Proven ability to multi-task, prioritize, and meet required deadlines
• High attention to detail and accuracy
• Thrive in a fast-paced continuously changing environment by balancing multiple deadline driven priorities
• Operate as a strong team player with a high degree of flexibility
• Exhibit excellent grammar, verbal and written communication skills
• Ability to learn quickly and use new technologies to enhance processes and efficiencies

Competencies

• Influencing
• Communication
• Process Management
• Priority Setting
• Peer Relationships
• Problem Solving
• Drive for Results
• Technical Learning
• Time Management

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.

• $23.89 — $31.35 USD

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