Orlando, FL, 32806, USA
7 hours ago
Senior Reimbursement and Market Access Specialist (REMOTE)
We are excited to be named one of the World’s Best Workplaces by Fortune Magazine! We are proud to offer you 12 paid holidays annually. For an overview of our benefits and time off, please follow this link to learn more:US Stryker employee benefits. (https://d25zu39ynyitwy.cloudfront.net/oms/000000/document/2024/6/SMVZW\_USStrykerEmployeebenefits/USStrykerEmployeebenefits.pdf) ​​ **What you will do:** As a Senior Market Access and Reimbursement Specialist, you will support the day-to-day reimbursement inquiries from the field sales representatives and physician, Ambulatory Surgical Center (ASC) , and hospital customers related to Interventional Spine (IVS) procedures. In this role, you will also review and support the periodic updates of coding documentation to ensure the accuracy of CPT, HCPCS, and ICD-10 coding. Additionally, you will conduct in-depth research on coding, coverage, and payment policies to effectively respond to customer and salesforce inquiries + ​Serves as point of contact for complex reimbursement inquiries, working with cross-functional teams to resolve issues. + ​Works closely with sales, marketing, patient access, and market access teams to ensure alignment on reimbursement strategy and execution. + ​Collaborates 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 to include site visits as needed. + ​Communicates with clinical and office staff, providers and salesforce regarding any missing, incomplete, or inconsistent documentation and to obtainaccurate billing codes as necessary. + ​Assists with the deployment of payer and provider focused communications regarding the value of Stryker IVS products + ​Manages 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 HIPAApolicies,guidelines and legal requirements to ensure compliance.​ **What you need:** Required: + Bachelor's degree plus 2 years of relevant experience or associate's degree plus 6 years of relevant work experience or 8 years of relevant work experience plus a high school diploma. Preferred: + 2+ years of experience in providing coding, coverage, and payment advice in a healthcare setting + 2+ years of experience with prior authorization, denials and appeals process + 2+ years of experience of coding guidelines, medical procedures and services to appropriately review OP reports/notes, rejected claims and EOBs + 2+ years of experience working with 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) is preferred. $69,100 - $139,600 salary plus bonus eligible + benefits. Actual minimum and maximum may vary based on location. ​ 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. Stryker Corporation is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Stryker is an EO employer – M/F/Veteran/Disability.
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