Reimbursement and Market Access Specialist - #250811

What you will do:

As our Reimbursement and Market Access Specialist, you will provide reimbursement expertise and support to both internal and external customers regarding all phases of the reimbursement procedures and related patient access activities to achieve the objective of successfully assisting procedures through the billing, reimbursement and appeals process.

• Supports the day-to-day reimbursement inquiries from the field sales and external physician, ASC, and hospital providers and customers for IVS products.
• Communicates reimbursement updates to customers as needed.
• Conducts basic research on reimbursement codes and policies, including CPT, HCPCS, ICD-9 & ICD-10, and payer guidelines.
• Answers and responds accurately and timely to questions on the telephone, voicemail, e-mail, Coding Hotline and/or Coding e-mail box as appropriate.
• Collaborate with customers to research, troubleshoot and resolve claim issues and reimbursement challenges.
• Provides support in the prior authorization, denial and appeals process to providers, clinical, office staff and salesforce.
• Communicates with clinical and office staff, providers and salesforce regarding any missing, incomplete, or inconsistent documentation and to obtain accurate billing codes as necessary.
• Assist with the deployment of payer and provider focused communications regarding the value of Stryker IVS products
• Manage all aspects of the Coding Hotline and Email contacts, responding to inquiries as needed, track and trend data related to contacts reporting information.
• Accurately follows Stryker HIPAA policies, guidelines and legal requirements to ensure compliance.
• May develop reimbursement tools and analytics to support the organization's strategic objectives and operational goals.
• Requires additional development and training to advance to Senior Specialist.
  
  

What you need:

Required:

• Bachelor's degree or Associate's degree plus 4 years of relevant work experience or 6 years of relevant work experience
  
  

Preferred:

• Experience in providing coding, coverage, and payment advice in a healthcare setting
• Experience with prior authorization, denials and appeals process
• Knowledge of coding guidelines, medical procedures and services to appropriately review OP reports/notes, rejected claims and EOBs
• Knowledge of Medicare, Medicare Advantage, Medigap and private/commercial payer methodologies
• Licensure or Certification: CPC (Certified Professional Coder through American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information Management Association)
  
  

$58,700 - $106,200 salary plus bonus eligible + benefits. Actual minimum and maximum may vary based on location. Individual pay is based on skills, experience, and other relevant factors.

Health benefits include: Medical and prescription drug insurance, dental insurance, vision insurance, critical illness insurance, accident insurance, hospital indemnity insurance, personalized healthcare support, wellbeing program and tobacco cessation program. Financial benefits include: Health Savings Account (HSA), Flexible Spending Accounts (FSAs), 401(k) plan, Employee Stock Purchase Plan (ESPP), basic life and AD&D insurance, and short-term disability insurance. Stryker offers innovative products and services in MedSurg, Neurotechnology, Orthopaedics and Spine that help improve patient and healthcare outcomes. Alongside its customers around the world, Stryker impacts more than 150 million patients annually. Depending on customer requirements employees and new hires in sales and field roles that require access to customer accounts as a function of the job may be required to obtain various vaccinations as an essential function of their role.