Reimbursement Specialist

Baxter International Inc.•Saint Paul, MN

2d•Hybrid

About The Position

This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. Your role at Baxter THIS IS WHERE you build trust to achieve results… 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 teams to coordinate in our mission of enhancing outcomes for patients and their caregivers. This is a full-time hybrid position where the candidate would report to the St. Paul office three days a week, Monday through Friday. The hours of operation are 8:30am - 5pm.

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
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

Nice To Haves

Third party payer experience strongly preferred.
Experience with Total Information Management System (TIMS) a benefit.

Responsibilities

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 Cardiology 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 agreement 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.

Benefits

Baxter offers comprehensive compensation and benefits packages for eligible roles.
Our health and well-being benefits include medical and dental coverage that start on day one, as well as insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance.
Financial and retirement benefits include the Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount, and the 401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching.
We also offer Flexible Spending Accounts, educational assistance programs, and time-off benefits such as paid holidays, paid time off ranging from 20 to 35 days based on length of service, family and medical leaves of absence, and paid parental leave.
Additional benefits include commuting benefits, the Employee Discount Program, the Employee Assistance Program (EAP), and childcare benefits.

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