Reimbursement Specialist

Job title: Reimbursement Specialist Location: Remote Pay Rate: $37/hr. on W2 Interviews: 3 to 4 rounds of Zoom Duration: 12 Months Summary: The GAVE (Global Access, Value & Economics) Analyst provides analytical and research support to projects for Reimbursement Operations. This role will contribute to GAVE projects such as policy, coverage and payment research. This role will work with internal teams to ensure timely, accurate, and value-added research, develop ad hoc analysis and presentations while creating and maintaining reference materials owned by the department. Essential Duties and Responsibilities: Key responsibilities include but are not limited to: • Maintain reimbursement and coding guide updates annually. Ensure newly cleared procedures are added to the guides every year and manage the Veeva approval process. • Develop new coding guides when necessary. • Contribute to research related coding questions from GAVE COE’s by partnering with coding consultant to maintain master coding spreadsheets (CPT, ICD-9, ICD-10) and facilitating communication. • Maintain coverage policy dashboards that highlight year over year coverage policy trends • Manage updates of Alternative Payment Methodology Pathways spreadsheets (NTAP, TPT, New Tech APC) for Emerging Technology research. • Research and extract relevant information from secondary data sources (i.e., CMS Website, EncoderPro, Policy Reporter) to provide insight into market access strategies. • Monitor Salesforce.com to support hospital customers. • Work with international leaders to develop yearly updates for the Global Reimbursement Compendium. Qualifications: • General understanding of healthcare reimbursement policy processes (coding, coverage, and payment) and how they impact the delivery of care to patients in the US. • Familiarity with AMA CPT coding and CMS payment methodologies in the US is a plus. • Proven ability to distill complex information into concise and impactful messages/presentations via email and PPT. • Strong project management, analytical and prioritization skills. Data collection, analysis, and visualization skills. Ability to merge data from various sources into cohesive tools (Excel, Tableau, SFDC). • Results oriented and natural data driven business acumen. • Self-motivated, self-starter, work independently or as part of a team, can help create structure within ambiguity. Ability to identify barriers and escalate to necessary stakeholders. • Excellent interpersonal skills. Willingness to learn and accept feedback and coaching. • Must be able to perform in a fast-paced, results-oriented, diverse and cross-functional matrix organization that focuses on a high degree of teamwork but balanced with self-directing independent effort. Education and/or Experience: • Bachelor’s degree with 2+ years’ hospital, healthcare or medical technology industry experience. • Advanced degree with experience in market access or patient research, health economics, medical affairs, or health policy preferred. Recent college graduates with relevant internship experience or academic research publications may also be accepted • Experience in health policy, reimbursement, payer insurance strategies/analytics or health care consulting are highly desired. Applicants with strong analytical skillsets such as finance, strategy consulting, sales and growth operations also encouraged to apply • Experience conducting research (primary and secondary) and developing market access (coding, coverage, payment) and pricing strategies for Client medical device, pharmaceutical, SaaS/SaMD, and diagnostic technologies preferred.