Senior Specialist of Contract and Reimbursement Strategy

bioM?rieux BV; Plymouth (Luzerne County); On-site; USD 103,000 - 176,000; Full time

Job summary

A leading global healthcare company is seeking a Senior Specialist for Contract and Reimbursement Strategy. This crucial role will drive billing, coding, and reimbursement strategies across healthcare settings. Candidates should have expertise in reimbursement processes, contract strategy development, and leadership skills. Join a team dedicated to making a world of difference for women and their communities.

Benefits

Retirement savings plan

Paid vacation and holiday time

Health benefits (medical, dental, vision)

Paid caregiver/parental and medical leave

Qualifications

• Minimum of five years of experience in a similar role within the healthcare industry.
• Strong background in payor access, contracting, and value-based modeling.
• Demonstrated ability to lead and inspire teams.

Responsibilities

• Develop and enhance billing and coding knowledge across different care settings.
• Lead the development of contracting strategies to optimize financial performance.
• Provide customer-facing support to resolve billing, coding, and reimbursement challenges.

Skills

Billing and Coding Expertise

Reimbursement Processes

Contract Strategy Development

Health Economics

Customer Engagement

Analytical Skills

Education

Bachelor's degree in healthcare administration or related field

Master's degree (preferred)

Certified Professional Coder (CPC)

Certified Revenue Cycle Representative (CRCR)

Certified Healthcare Financial Professional (CHFP)

Tools

Epic

Cerner

Job description

Job Description

The Position

We are seeking a highly skilled and experienced professional to join our team as the Senior Specialist of Contract and Reimbursement Strategy. This role is essential in developing and implementing strategies that support billing, coding, and reimbursement processes across diverse healthcare settings, including hospitals today and midwifery practices and birth centers in the future. The ideal candidate will possess deep expertise in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and Medicaid. The role will also support the development of a contracting strategy for the MedTech business.

Responsibilities

• Billing and Coding Acumen:Develop and enhance billing and coding knowledge across different settings of care, ensuring accurate and efficient physician billing.

• Reimbursement Expertise:Serve as an expert in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and Medicaid. Serve as an expert on DRG hospital and provider reimbursement.

• Customer Engagement:Provide customer-facing support to troubleshoot billing, coding, and reimbursement challenges, ensuring high levels of satisfaction and resolution.

• Contract Strategy Development:Lead the development of contracting strategies to optimize financial performance and compliance. Strong understanding of CMS rules, stark law, anti-kickbacks in medical device space. In addition, the role will support contract analytics and execution support efforts.

• Resource Development:Create and maintain reimbursement resources to support internal teams and external partners.

• Payer Marketing:Develop and implement marketing strategies to enhance payer relationships and reimbursement outcomes.

• Health Economics:Develop health economics strategies and resources with focus on reduction in healthcare costs, revenue cycle management, cost avoidance, and cost consequence analysis.

• Systems Expertise: proficiency in reimbursement and billing systems such as Epic and Cerner.

Required Education, Experience and Skills

• Bachelor's degree in healthcare administration, business, or a related field (Master's preferred).

• Professional certifications suggest certified professional coder (CPC, certified revenue cycle representative (CRCR), or certified healthcare financial professional (CHFP) preferred.

• Extensive experience in billing, coding, and reimbursement processes.

• In-depth knowledge of inpatient and maternal health settings.

• Proven track record in strategy development and resource creation.

• Strong background in payor access, contracting, value-based modeling, and contract analytics.

• Experience in payer marketing and relationship management.

• Leadership:Demonstrated ability to lead and inspire teams to achieve strategic goals.

• Collaboration:Strong collaborative skills to work effectively with cross-functional teams and external partners.

• Customer Engagement:Excellent customer engagement skills to address and resolve billing and reimbursement issues.

• Analytics:Expertise in evaluating customer and contract performance data to identify and deliver recommendations to business leaders.

• Minimum of five (5) years of experience in a similar role within the healthcare industry.

• Strong analytical and problem-solving skills.

• Excellent communication and interpersonal skills.

• Ability to travel up to 25% of the time.

Who We Are:

Organon delivers ingenious health solutions that enable people to live their best lives. We are a $6.5 billion global healthcare company focused on making a world of difference for women, their families and the communities they care for. We have an important portfolio and are growing it by investing in the unmet needs of Women’s Health, expanding access to leading biosimilars and touching lives with a diverse and trusted portfolio of health solutions. Our Vision is clear: A better and healthier every day for every woman.

US and PR Residents Only

For more information about personal rights under Equal Employment Opportunity, visit:

EEOC Poster

EEOC GINA Supplement

OFCCP EEO Supplement

OFCCP Pay Transparency Rule

Organon is an Equal Opportunity Employer. We are committed to fostering a culture of inclusion, innovation, and belonging for all employees and job applicants. We ensure all employment practices are conducted without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability, veteran status, or any other characteristic protected by state or federal law.

Search Firm Representatives Please Read Carefully
Organon LLC., does not accept unsolicited assistance from search firms for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

Applicable to United States Positions Only: Under various U.S. state laws, Organon is required to provide a reasonable estimate of the salary range for this job. Final salary determinations take a number of factors into account including, but not limited to, primary work location, relevant skills, education level, and/or prior work experience. The applicable salary range for this position in the U.S. is stated below. Benefits offered in the U.S. include a retirement savings plan, paid vacation and holiday time, paid caregiver/parental and medical leave, and health benefits including medical, prescription drug, dental, and vision coverage in accordance with the terms and conditions of the applicable plans.

Annualized Salary Range (US)

$103,100.00 - $175,300.00

Please Note: Pay Ranges are Specific to local market and therefore vary from country to country

Employee Status:

Regular

Relocation:

No relocation

VISA Sponsorship:

No

Travel Requirements: Organon employees must be able to satisfy all applicable travel and credentialing requirements, including associated vaccination prerequisites.

25%

Flexible Work Arrangements:

Not Specified

Shift:

Not Indicated

Valid Driving License:

Yes

Hazardous Material(s):

Number of Openings:

1

Requisition ID:R534291