At Tactile Medical, we specialize in developing at-home therapy devices to treat lymphedema, chronic venous insufficiency and respiratory illnesses.
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
Our total compensation package includes medical, dental and vision benefits, retirement benefits, employee stock purchase plan, paid time off, parental leave, family medical leave, volunteer time off and additional leave programs, life insurance, disability coverage, and other life and work wellness benefits and discounts. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.
Below is the starting salary or hourly range for this position, although offers may differ based on the candidate's location, job-specific knowledge, skills and experience.
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Skills Required
- Bachelor's degree or equivalent work experience
- 3+ years of experience working within medical insurance or billing
- 2+ years of outbound and inbound patient interaction experience within the healthcare or medical device industry
- Previous experience with prior authorizations
- Experience with outpatient durable medical equipment billing, including rental products
What We Do
Tactile Medical is one of the fastest growing companies in medical devices. As a leader in treatment options for lymphedema and venous ulcer therapies, Tactile Medical develops advanced home therapy devices to improve health and quality of life for patients with chronic swelling . Headquartered in Minneapolis, Minnesota, we advocate for patient access and serve tens of thousands of patients through a direct national network of product specialists and trainers, reimbursement experts, patient advocates, and clinical staff.
