Advanced Respiratory, Inc Reimbursement Specialist (Hybrid) in St. Paul, Minnesota
This is where you save and sustain lives At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You'll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients. Baxter's products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 85 years, we have pioneered significant medical innovations that transform healthcare. Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work. Join us at the intersection of saving and sustaining lives- where your purpose accelerates our mission. Your role at Baxter In this role you will perform Reimbursement Specialist duties for assigned territory or payer(s) including eligibility and benefit verification, documentation collection, prior authorization and reauthorization submissions, letter of agreement payment negotiations, and processing payer decisions. As the Reimbursement Specialist you will communicate directly with patients, healthcare teams, and insurance companies as well as collaborating cross-functionally with other Respiratory Health teams to coordinate in our mission of enhancing outcomes for patients and their caregivers. What you'll be doing Perform verification of eligibility and benefits to determine coverage and payer requirements Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims Gather clinical documentation to support medical necessity for Respiratory Health products Assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid Process authorization decisions from payers timely to streamline and drive revenue Negotiate payment rates for letter of agreements to ensure maximum collection potential Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance Consistently contribute to team goals and understand how they support greater organizational goals Actively seek additional experience and knowledge across all functional areas to gain expertise and perform other duties and projects as assigned What you'll bring Associates degree or higher preferred 3+ years of industry experience, preferably in health insurance and/or durable medical equipment Third party payer experience strongly preferred Exceptional written, verbal, and interpersonal communications Strong critical thinking and problem-solving skills Detail orientated and ability to multi-task Ability to work independently as well as in a team environment Possess the ability to manage time and prioritize critical priorities Proficiency in Microsoft Office Software Experience with Total Information Management System (TIMS) a benefit We understand compensation is an important factor as you consider the next step in your career. At Baxter, we are committed to equitable pay for all employees, and we strive to be more transparent with our pay practices. The estimated base salary for this position is $36,000 to $90,000 annually. The estimated range is meant to reflect an anticipated salary range for the position. We may pay more or less than of the anticipated range based upon market data and other factors, all of which are subject to change. Individual pay is based on upon location, skills and expertise, experience, and other relevant factors. For questions about this, our pay philosophy, and available benefits, please speak to the recruiter if you decide to apply and are selected for an interview. #LI-VS1 The successful candidate for this job may be required to verify that he or she has been vaccinated against COVID-19, subject to reasonable accommodations for individuals with medical conditions or religious beliefs that prevent vaccination, and in accordance with applicable law. Equal Employment Opportunity Baxter is an equal opportunity employer. Baxter evaluates qualified applicants without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, protected veteran status, disability/handicap status or any other legally protected characteristic. EEO is the Law EEO is the law - Poster Supplement Pay Transparency Policy Reasonable Accommodations Baxter is committed to working with and providing reasonable accommodations to individuals with disabilities globally. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application or interview process, please click on the here and let us know the nature of your request along with your contact information. 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