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Reimbursement Specialist

2 months ago

Saint Paul, Minnesota, United States Hill-Rom Full time
About the Role

We are seeking a highly skilled Reimbursement Specialist to join our team at Baxter. As a key member of our Respiratory Health team, you will play a critical role in ensuring that patients receive the necessary medical equipment and services to improve their health outcomes.

Key Responsibilities
  • Verify patient eligibility and benefits to determine coverage and payer requirements.
  • Ensure accurate benefit information is loaded 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.
  • Process authorization decisions from payers in a timely manner to streamline revenue.
  • Negotiate payment rates for letter of agreement to maximize collection potential.
  • Provide exceptional customer service by communicating effectively with patients and healthcare teams about payer policies, coverage criteria, and benefit limitations.
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 multitask.
  • Ability to work independently and as part of a team.
  • Proficiency in Microsoft Office software.
  • Experience with Total Information Management System (TIMS) a plus.
What We Offer

Baxter is committed to supporting the needs of our employees and offers a flexible workplace policy, including a minimum of 3 days a week onsite. We strive to be transparent with our pay practices and offer equitable compensation for all employees. The estimated base salary for this position is $41,600 to $57,200 annually.

We are an equal opportunity employer and welcome applications from diverse candidates. If you require reasonable accommodations during the application or interview process, please let us know.