- Serve as the primary contact for reimbursement support and educate new and existing customers on billing, coding, how to submit claim forms, national and local coverage policies, and good clinical documentation.
- Act as the key liaison between the Reimbursement Hotline, providers, and Sales for monitoring and addressing issues related to insurance verification requests (IVR) using cloud-based workflow solutions.
- Educate providers and staff on payer policies, coverage criteria, claims issues, den2als, and appeals related to S+N products.
- Develop, utilize, and improve internal systems, processes, and tools for improving patient access in collaboration with Sales, Hotline, and Market Access colleagues.
- Monitor regional policy changes and work closely with the Market Access and the Hotline to ensure company has the latest coding information, coverage policies, claims outcomes, and treatment guidelines.
- Roles are field based.
- Northwest – OR, WA, ID, UT, MT, ND, SD
- Central– MN, WI, IA, MO, NE, KS, CO
- Bachelor’s Degree in the business, health sciences, management, healthcare administration or related field
- Advanced degree (MBA, MS, etc.) Preferred
Licenses/ Certifications: Certified Professional Coder is a plus
- 8+ years of experience in biotechnology, pharmaceutical, medical device, or medical/hospital management industry
- 3+ years of experience in reimbursement, billing and coding within the healthcare, biotechnology, pharmaceutical, wound care or surgical device fields
- Comprehensive knowledge of healthcare reimbursement practices, billing procedures, compliance, coding, and medical terminology
- Strong background in sales, management, or reimbursement for “buy and bill” products in the biotechnology industry related to biologics, wound care and/or surgical procedures preferred
- Experience in wound care ICD-10 codes, coding, and billing preferred