Reimbursement Specialist

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
• Technical Learning
• Time Management