Remote Clinical Appeals Advocate - Patient Access Champion

Baxter International Inc.; Illinois; Remoto; USD 60.000 - 83.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical and dental coverage from day 1

401(k) with company match

Employee stock purchase plan (ESPP)

Paid time off 20–35 days

Descrizione del lavoro

Baxter International Inc. is seeking a Clinical Appeals Advocate to support patients denied coverage for Respiratory Health products. You will work with patients, care teams, and payers to overturn denials and secure access to therapies.

This remote US role emphasizes clinical insight and payer navigation. You will collaborate cross-functionally, manage documentation, and communicate complex policies clearly to patients and healthcare partners, ensuring a positive patient experience throughout

Competenze

• Active nursing licensure (RN/RT/LPN) required and state-licensed.
• Minimum 3 years reviewing medical records for reimbursement preferred.
• Knowledge of HIPAA and payer guidelines.
• Strong written and verbal communication and organization.
• Proficiency with Microsoft Office and related software.

Mansioni

• Assess cases and develop appeal strategies with supporting clinical documentation.
• Explain appeal strategies to patients and prepare for hearings if needed.
• Create clinical case summaries and strengthen documentation for payers.
• Process favorable decisions and negotiate resolutions when denials persist.
• Build relationships with case managers and medical directors to improve outcomes.
• Explain payer policies and coverage criteria to patients and teams for informed decisions.
• Ensure compliance with Baxter and payer policies and contribute to team goals.

Conoscenze

Communication skills

Microsoft Office

Multitasking

Critical thinking

Clinical documentation

Formazione

Nursing license (RN/RT/LPN) active in state

Associate degree or higher in clinical/reimbursement field

Descrizione del lavoro

Baxter International Inc. is seeking a Clinical Appeals Advocate to support patients denied coverage for Respiratory Health products. You will work with patients, care teams, and payers to overturn denials and secure access to therapies.

This remote US role emphasizes clinical insight and payer navigation. You will collaborate cross-functionally, manage documentation, and communicate complex policies clearly to patients and healthcare partners, ensuring a positive patient experience throughout