Reimbursement Specialist

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

Job summary

Tactile Medical in Minneapolis develops at-home therapy devices for lymphedema and related conditions. The Reimbursement Specialist collaborates with patients, clinicians, payers, and field teams to obtain and provide information to move orders, secure authorizations, and maintain HIPAA compliance.

Requirements include a bachelor’s degree or equivalent, 3+ years in medical insurance or billing, and 2+ years of patient interaction in healthcare or medical device settings.

Qualifications

• Bachelor’s degree or equivalent work experience.
• 3+ years in medical insurance or billing.
• 2+ years of patient interaction in healthcare or medical device industry.
• Knowledge of authorization processes and payer methodologies is preferred.

Responsibilities

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

Skills

Medical insurance knowledge

Payer communication

Organizational skills

Time management

Attention to detail

Verbal & written communication

Team collaboration

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