- Treatment for obstructive sleep apnea
- Minimum ten (10) plus years of work experience in reimbursement/market access/health economics for a medical technology/device company, health care consulting firm, insurance company, healthcare delivery system, physician's office and/or hospitals.
- Demonstrated knowledge and understanding of U.S. healthcare reimbursement mechanisms (Medicare prospective payment systems, third-party payer coverage, clinical and procedural coding) and regulations related to
reimbursement for medical technology products. - Able to work independently, cross functionally and as part of a team to problem solve and seek advice when necessary performing work with limited oversight and supervision.
- Able to make recommendations and implement process improvement opportunities.
- Able to manage multiple tasks with high degree of organization-prioritization skill and attention to detail and accuracy.
- Excellent verbal and written communication skills. Must have demonstrated comfort and capability routinely communicating with patients, physicians, hospital billers, and sales representatives.
- Strong computer skills (Excel, Word, PowerPoint).
- Experience in providing coding, coverage, and payment advice in a healthcare setting with an emphasis on implantable devices preferred.
- Successful strategic coding and policy development and execution.
- Bachelor's degree in business, science or healthcare administration required.
- Serve as subject matter expert for internal and external customers regarding all existing and newly established coding, coverage and payment associated with Inspire.
- Assist with the development and maintenance of coding, coverage, and payment information and tools that supports customer understanding and education.
- Provide support and analysis to the field in the areas of US reimbursement rules and regulations for Inspire.
- Maintain a comprehensive knowledge of the rules and regulations of CMS as well as major commercial payers.
- Contribute to solutions for reimbursement coding, payment and coverage challenges for commercialized products.
- Partner with other team members and the US Sales team on critical coding, coverage and payment hospital focused messages and development of tools and customer resources.
- Contribute to reimbursement education programs to internal and external constituents. These programs can include training, best practice sharing, and delivery and sharing of reimbursement expertise and knowledge.
- Prepare and deliver training and education webinars and presentations to internal and external audiences on Reimbursement topics.
- Development and update of payment spreadsheets/calculators to provide account specific payment information.
- Contribute to and project manage cross-functional projects such as reimbursement collateral development and field-based training seminars.
- Track and report project status, timelines, and findings, highlight successes, and measure the contribution of outputs to the business.
- Document product and therapy related field reports within the prescribed timelines and provide any necessary documents required to complete the investigation. Provide follow-up reporting as needed.
- Complete training requirements and competency confirmations as required for this position within the required timeline.
- Comply with applicable quality system procedures/policies and make suggestions for continuous process improvement.
- Base Salary: Upper 100k's
- Acceptable Candidate Location: Hybrid role
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Description
Job Description
The Reimbursement Senior Manager will support the day to day reimbursement needs for both internal and external customers. The Reimbursement Senior Manager will utilize analytical and critical thinking skills/experience to help solve complex reimbursement related problems and work directly with customers to ensure they are fully trained on Inspire billing and coding practices. The Reimbursement Senior Manager should be experienced in the area of third-party (commercial) and government reimbursement process and policies, particularly as it relates to supporting hospital and physician customers. The role will contribute regularly to developing and distributing materials regarding key Inspire reimbursement information to the appropriate groups. The Reimbursement Senior Manager will serve as a key partner to customers (physicians and hospitals) and the Inspire sales team in assisting with coding and claims issues/denials and providing overall reimbursement support. This role will report to the Director of Market Access.
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