Field Reimbursement Specialist

At MIMEDX, our purpose starts with helping humans heal. We are driven by discovering and developing regenerative biologics utilizing human placental tissue to provide breakthrough therapies addressing the unmet medical needs for patients across multiple areas of healthcare. Possessing a strong portfolio of industry leading advanced wound care & surgical products combined with a promising clinical pipeline, we are committed to making a transformative impact on the lives of patients we serve globally.

We are excited to add a Field Reimbursement Specialist to our sales team! The position will pay between $49,500 - 80,000k based on previous relevant experience, educational credentials, and location.

POSITION SUMMARY:

The Field Reimbursement Associate will report to the Regional Reimbursement Director and provide support to the Field Reimbursement Managers (FRMs) in a designated Region(s) to help navigate the patient access and reimbursement landscape to MIMEDX products.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Assist Field Reimbursement Managers (FRMs) in a designated Region(s)
• Work as liaison between field sales and customers to provide information required for timely completion of Insurance Verification Request (IVR) cases with the Patient Insurance Verification Team (PIVT)
• Investigate all denied or partially paid services and provide guidance regarding next steps and support needs alongside the FRM
• Conduct claim reimbursement reviews to monitor accurate payments; provide detailed analysis and identify billing errors alongside the FRM
• Conduct quarterly consignment product audits with Account Executives in the field
• Assist FRM(s) on monthly Regional calls in providing education and updates to Account Executives
• Assist FRM(s) on running IVR reports for Account Executive and customers
• Adhere to HIPAA policies and procedures to ensure compliance

EDUCATION/EXPERIENCE:

• BS/BA in related discipline. Certification may be required in some areas.
• 0-2 years of experience in related field, or verifiable ability,

OR

• MS/MA/MBA and 0-1 years of experience in related field
• 1-2 years of experience in insurance verification, billing/claims processing, data processing
• Good knowledge of medical coding including ICD10, CPT and HCPCS codes
• Good understanding of Medicare, Medicaid, and Commercial and health plans
• Good understanding of medical management, health insurance concepts, information systems
• Good understanding of HIPAA rules

SKILLS/COMPETENCIES:

• Excellent oral, written, and interpersonal communication skills
• Ability to interact with all levels of management, both internal and external, third party payers, and customers
• Organized, flexible, and able to multi-task while maintaining a high level of efficiency and attention to detail
• Strong analytical skills, clinical interests, strategic and technical analysis and problem-solving skills
• Ability to influence others to achieve desired results using tenacity and diplomacy
• Fully competent and productive professional contributor, working independently on larger, moderately complex projects/assignments that have direct impact on department results

WORK ENVIRONMENT:

• The work is typically performed at home. Travel is limited (~up to 25%)

At MIMEDX, we are committed to fair and equitable pay practices. We pay our employees equitably for their work, commensurate with their individual skills and experience. Salary ranges and additional compensation, including discretionary bonuses and incentive pay, are determined by a rigorous review process. Salary ranges consider the experience, education, certifications, and skills required for the specific role, equity with similarly situated employees, as well as employer-verified US region specific market data provided by an independent 3^rd party partner. Individual salaries vary depending on factors such as your experience, education, location and special skill set. In addition, MIMEDX offers competitive benefits including healthcare, 401k savings plan, ESPP, vacation, and parental leave.

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to, or requirements for, this job at any time.