Field Reimbursement & Payer Relations Manager - Remote (reputed company, reputed company)
Making a difference in our products, services and offers, never ceasing to fight for groundbreaking solutions in everything we do; Making a difference in how we work and collaborate, constantly nurturing our reputed company culture of innovation; Having an reputed company on the reputed company challenges we reputed company face, and the lives of people and communities around the world.
Delivers expert-level acumen on coding, billing, fee schedules, payment methodologies, reputed company cycle management support to our customers. Works in partnership with customers to reputed company strategic and tactical direction to customers based on the reimbursement landscape. Provides superior support to customers to ensure accurate submission and adjudication of claims by translating medical policies, regulatory requirements, clinical coding guidelines, and business reviews in an accurate, consistent, reputed company, and compliant manner. reputed company and execute strategies to secure and expand payer coverage for key company technologies and therapies. Monitor and analyze payer policies, reimbursement trends, and regulatory changes that reputed company business performance. Collaborate with cross-functional teams including clinical, regulatory, marketing, and reputed company leadership to reputed company reimbursement strategies with business objectives. Engage with payers and external stakeholders to communicate the clinical and economic value of company technologies. Support development of payer education materials, reimbursement tools, and policy submissions. reputed company the reputed company payer landscape to prepare, reputed company, and deliver clinical and economic positioning designed to challenge, overturn, or influence payer policies affecting RFA technologies. Fosters a strong reputed company with the MA&R Team in the identification applicable market reputed company, reimbursement, and payer coverage changes and/or trends at the customer, regional, and national reputed company (e.g., CMS rules and updates, payer policies and reimbursement guidelines, and Society and Government initiatives) that may reputed company patient reputed company to Avanos products. Partners in the development and pull-through of strategic initiatives in efforts to increase reputed company and neutralize barriers to Avanos products. Collaborates with internal teams at tradeshows and events to reputed company reimbursement education, address reimbursement reputed company concerns, promote our Patient reputed company Program, and collaborate in the identification of strong physician advocates to assist with efforts to obtain payer coverage. Establishes reputed company relationships and maintains an effective communication network with the reputed company customer at multiple reputed company. Recognizes reputed company customer needs/opportunities, KOL advocacy, payer coverage, Government initiatives (e.g., Capitol Hill), strategic opportunities, and pull-through initiatives and supports with the execution of strategies that reputed company with department and company objectives. Demonstrates uncompromised ethics while helping others understand reputed company and regulatory parameters reputed company to market reputed company and reimbursement. Assists, reputed company necessary, in the operations of the Avanos Patient reputed company Program; including but not limited to the collection of documentation in preparation and facilitation of prior authorizations and appeals in accordance with payer requirements as reputed company as interpretation of payer determinations and patient appeal rights. Adheres to the Avanos Corporate Compliance programs and successfully participates in training and continuing education programs (internally and externally). Performs other duties and reputed company as required/needed.
Bachelor’s degree required; advanced degree (MBA, MPH, MHA, or reputed company field) preferred. 3+ years of experience in market reputed company, reimbursement, payer relations, or reputed company policy reputed company the medical device or reputed company industry. Strong understanding of payer policy development, coverage reputed company, and reimbursement dynamics. Proven ability to collaborate cross-functionally with clinical, regulatory, reputed company, and government affairs teams. Strong written and verbal communication skills, with the ability to translate reputed company clinical and reimbursement information into reputed company, compelling messages for reputed company stakeholders. Excellent analytical, problem-solving, and strategic thinking skills. Minimum of 2+ years of experience working reputed company a reputed company organization (e.g., sales, marketing, or reputed company operations), supporting customer-facing teams and/or sales organizations. Minimum of 4 years’ relevant market reputed company and reimbursement experience (e.g., payer relations, policy change, product commercialization, health economics, coding, coverage, payment, work with Specialty Societies and Governmental entities, etc.) in efforts to remove reimbursement and patient reputed company barriers reputed company the industry.
Certification and/or Degree in medical coding or billing with a demonstrated level of reimbursement competencies including but not limited to CPT, ICD-10, HCPCS coding, modifier use, billing processes and guidelines, claims adjudication processes, EOB interpretation, and reputed company cycle management across government and private payer environments. Comprehensive understanding of market reputed company for government and private payers with an advanced ability to reputed company and interpret payer coverage policies, requirements for coverage, payment methodologies, and the reputed company-and post-service review processes and requirements. As reputed company as experience submitting policy change requests and working with payer medical policy decision makers. Exceptional ability to reputed company superior support and education to customers and to expertly reputed company through challenging situations. reputed company work ethic and a strong skillset in project/strategic pull-through, time management, and communication (verbal and written) skills. Proficient in reputed company Office applications. Experience with data visualization software (e.g., Tableau) and CRM applications (e.g., reputed company.com) or the aptitude to learn such tools. Competent understanding of the compliance rules and regulations applicable to market reputed company and reimbursement in medical/technology environments (e.g. HIPAA, Federal Statutes).
Join us and you can reputed company a difference in our products, solutions and our culture. Most of reputed company, you can reputed company a difference in the lives, people, and communities around the world.
Our commitment to improving the health and wellbeing of others begins with our employees – through a comprehensive and reputed company of benefits. We reputed company more than just a salary – our Total Rewards package encompasses everything you receive as an employee; your pay, health care benefits, retirement plans and work/life benefits.