Respiratory Health Specialist

2 weeks ago


Saint Paul, Minnesota, United States Advanced Respiratory Full time
Enhance Patient Outcomes with Advanced Respiratory

At Advanced Respiratory, we are dedicated to saving and sustaining lives through innovative medical solutions. As a Reimbursement Specialist, you will play a vital role in ensuring our products and therapies reach those who need them most.

Key Responsibilities:
  • Verify patient eligibility and benefits to determine coverage and payer requirements
  • Ensure accurate benefit information to reduce rework and facilitate clean claims
  • Gather clinical documentation to support medical necessity for Respiratory Health products
  • Assess clinical documentation to ensure compliance with prescription, face-to-face, and coverage criteria requirements
  • Prepare and submit prior authorization requests to insurance companies, including commercial and government payers
  • Negotiate payment rates for letter of agreement to maximize collection potential
  • Provide exceptional customer experience by discussing payer policies, coverage criteria, benefit limitations, and product information with patients and healthcare teams
  • Understand and adhere to all policies for Advanced Respiratory and 3rd party payers to ensure the highest standards of quality and compliance
Requirements:
  • Associate's 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 communication skills
  • Strong critical thinking and problem-solving skills
  • Detail-oriented and ability to multi-task
  • Ability to work independently and in a team environment
  • Proficiency in Microsoft Office Software
  • Experience with Total Information Management System (TIMS) a benefit
What We Offer:
  • Estimated base salary: $41,600 to $57,200 annually
  • Flexible workplace policy with a minimum of 3 days a week onsite
  • Commitment to equitable pay for all employees
  • Opportunities for professional growth and development

At Advanced Respiratory, we are committed to creating a workplace where everyone feels valued, respected, and empowered to contribute their best work. If you are passionate about making a difference in the lives of patients and their caregivers, we encourage you to apply for this exciting opportunity.



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