Strategic Payer Reimbursement Specialist

Zvh; Saint Paul (MN); On-site; USD 42,000 - 57,000; Full time

Benefits offered by this job

Medical and dental coverage starting/1

ESPP and 401(k) matching

Paid holidays

Paid time off 20–35 days

Commuting benefits

Employee Discount Program

Employee Assistance Program (EAP)

Childcare benefits

Job summary

Baxter is seeking a qualified candidate to join our Healthcare Payer Operations team in Minnesota. The role focuses on verification of eligibility and benefits, documentation gathering for medical necessity, and submitting prior authorization requests to both commercial and government payers.

The ideal candidate brings 3+ years in health insurance, strong communication skills, and the ability to work both independently and in a collaborative setting.

Qualifications

• 3+ years of industry experience, preferably in health insurance or durable medical equipment.
• Strong written, verbal, and interpersonal communications.
• Ability to work independently as well as in a team environment.

Responsibilities

• Verify eligibility and benefits to determine coverage and payer requirements.
• Ensure benefit information is loaded correctly to reduce rework and enable clean claims.
• Gather clinical docs to support medical necessity for Respiratory Health products.
• Submit prior authorization requests for commercial and government payers (Medicare/Medicaid).
• Process authorization decisions timely to streamline revenue.
• Negotiate payment rates for letters of agreement to maximize collection.
• Provide excellent customer experience discussing payer policies and product information with patients and healthcare teams.

Skills

Health insurance experience

Payer communications

Critical thinking

Detail oriented

Tools

TIMS

Job description

Baxter is seeking a qualified candidate to join our Healthcare Payer Operations team in Minnesota. The role focuses on verification of eligibility and benefits, documentation gathering for medical necessity, and submitting prior authorization requests to both commercial and government payers.

The ideal candidate brings 3+ years in health insurance, strong communication skills, and the ability to work both independently and in a collaborative setting.