- Be the subject matter expert on coding, coverage, and payment for Medicare and commercial payers and impact patient access through complex problem solving
- Effectively communicate and explain Inspire reimbursement education, support, and resources to customers in multiple sites of service including administrators
- Both proactively and reactively navigate and address individual account and patient access issues that occur by partnering with external and internal stakeholders including internal reimbursement team and field sales colleagues
- Respond to client and internal partner requests for customer site visits, Inspire program business reviews, and reimbursement needs/support
- Establish and maintain customer relationships through reimbursement related engagement and cross-functional partnerships including Sales, Marketing, Medical Education, and Legal and Compliance, etc.
- Execute on access and reimbursement strategic priorities, working with business partners to identify and prioritize key accounts for alignment of reimbursement support to achieve goals
- Collaborate in the development of reimbursement presentations for site visits, trainings, client presentations and other meetings as appropriate
- Keep abreast of ever-changing market dynamics and industry trends Inspire related impacts regarding to CMS and commercial payers
- Work in a fast-paced environment and manage additional related responsibilities based on organizational needs
- Build a culture of compliance that ensures that all activities are fully aligned with company quality system procedures/policies, applicable laws, regulations, and industries standards
- Bachelor's degree in business, science or healthcare administration required
- Minimum 5-7 years of work experience in reimbursement/market access
- Demonstrated knowledge in coding, coverage, and payment for implantable medical devices across the healthcare landscape including HCPs, ASCs, hospitals
- Experience engaging directly with HCPs in multiple sites of service and in group educational settings
- Excellent communication and in person and virtual presentation skills to interface with customers, cross-functional partners, and internal reimbursement and prior authorization partners
- Independent and team-oriented problem solving and diligent self-motivated follow up
- Direct experience collaborating with multiple internal and external stakeholders and managing projects
- Successful experience working with complex insurance payer claims, denials, and appeals (Medicare and commercial)
- Ability to travel regularly and up to 50%+
- Located in East, Midwest, or West territories
- Neurology experience
- Coding certification (CPC, COC)
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Field Reimbursement Manager - Golden Valley, United States - Inspire Medical Systems, Inc.
Description
ABOUT INSPIRE MEDICAL SYSTEMS
Inspire is the first of its kind medical device designed to make a difference in the lives of those living with Obstructive Sleep Apnea (OSA). We are revolutionizing the sleep industry with our FDA-approved medical device, designed to reduce OSA severity for those who cannot tolerate or get consistent benefit from CPAP. Our focus on patient outcomes is at the core of everything we do, and our "think I can" attitude drives us to make a difference in the lives of those seeking alternative sleep apnea treatments.
WHY JOIN OUR FAST-GROWING TEAM
At Inspire, we value people - your diverse experiences, backgrounds, and thoughts. We elevate voices and encourage learning opportunities to build a professional network that grows into community. We embrace a people-first culture by offering hybrid work schedules, excellent benefits, 401k matching, ESPP, flexible time off (FTO), and tuition reimbursement.
If you're passionate about making a difference in people's lives and want to work with innovative technology, come be a part of our great team
ABOUT THIS POSITION
Are you ready for a challenging, yet impactful role? The Field Reimbursement Manager (FRM) role is instrumental in providing support to optimize Inspire access and minimize reimbursement barriers for patients and providers. This position is provider/customer-facing and requires the ability to build relationships with providers, providers' offices, Ambulatory Surgery Centers, hospital outpatient facilities, as well as other cross functional internal and external stakeholders. The FRM works both independently in a fast paced, highly visible environment as well as collaboratively with the internal program prior authorization support services and field sales to ensure all customer needs are met supporting patient therapy access. A candidate will have implantable medical device experience to leverage in solving complex reimbursement issues, overcoming claim denials, plus prior therapy access strategic support successes. They will also actively engage with new accounts for billing and coding training, audit education, and program review support. Experience with Neurology products is a plus. Must have a strong working knowledge of Medicare and commercial insurance and be able to relay detailed medical criteria information in order to maximize the HCP and staff experience. Position will require regular to 50% plus travel, project management and/or account coordination with other stakeholders.
The FRM role will also provide market insights and work collaboratively with both field-based teams (eg sales) and internal stakeholders in communicating coverage challenges across specific payer channels with guidance on how to navigate and minimize those potential hurdles.
OPPORTUNITIES YOU WILL HAVE IN THIS ROLE
Required Qualifications
Preferred Qualifications
Inspire Medical Systems provides equal employment opportunity (EEO) to all employees and applicants without regard to race, color, religion, creed, sex, national origin, age, disability, marital status, familial status, sexual orientation, status regarding public assistance, membership or activity in a local commission, military or veteran status, genetic information, or any other status protected by applicable federal, state, and local laws. This policy applies to all aspects of the employment relationship, including recruitment, hiring, compensation, promotion, transfer, disciplinary action, layoff, return from layoff, training, and social and recreational programs. Inspire Medical Systems complies with applicable laws governing non-discrimination in employment in every location in which Inspire Medical Systems has facilities. All such employment decisions will be made without unlawfully discriminating on any prohibited basis.
Inspire Medical Systems is anequal opportunityemployer with recruitment efforts focused on ensuring a diverse workforce.Applicants with a disability that need accommodation to complete the Inspire Medical Systems application process should contact Human Resources at or email (dot)com
Inspire Medical Systems participates in E-Verify.
#LI-AM1
Inspire Medical Systems provides equal employment opportunity (EEO) to all employees and applicants without regard to race, color, religion, creed, sex, national origin, age, disability, marital status, familial status, sexual orientation, status with regard to public assistance, membership or activity in a local commission, military or veteran status, genetic information, or any other status protected by applicable federal, state and local laws. This policy applies to all aspects of the employment relationship, including recruitment, hiring, compensation, promotion, transfer, disciplinary action, layoff, return from layoff, training and social and recreational programs. Inspire Medical Systems complies with applicable laws governing non-discrimination in employment in every location in which Inspire Medical Systems has facilities. All such employment decisions will be made without unlawfully discriminating on any prohibited basis.
Inspire Medical Systems is an equal opportunity employer with recruitment efforts focused on ensuring a diverse workforce. Applicants with a disability that are in need of accommodations to complete the Inspire Medical Systems application process should contact Human Resources at or email