Reimbursement Specialist

Baxter International Inc.•St. Paul, MN

4d•$41,600 - $57,200•Hybrid

About The Position

At Baxter, the Reimbursement Specialist supports the company’s mission to save and sustain lives by coordinating reimbursement activities for an assigned territory or payer group. The role handles eligibility and benefit verification, documentation collection, prior authorization and reauthorization submissions, letter-of-agreement payment negotiations, and payer decision processing. The specialist communicates directly with patients, healthcare teams, and insurance companies and collaborates with Respiratory Health teams to coordinate services and support outcomes for patients and caregivers. The position requires a minimum of three days onsite per week under Baxter’s flexible workplace policy. The estimated base salary is $41,600 to $57,200 annually. Actual pay may vary according to location, skills, expertise, experience, and other relevant factors.

Requirements

At least 3 years of industry experience, preferably in health insurance and/or durable medical equipment.
Exceptional written, verbal, and interpersonal communication skills.
Strong critical-thinking and problem-solving skills.
Detail-oriented with the ability to multitask.
Ability to work independently and in a team environment.
Ability to manage time and prioritize critical tasks.
Proficiency in Microsoft Office software.

Nice To Haves

Third-party payer experience is strongly preferred.
Experience with Total Information Management System (TIMS) is beneficial.

Responsibilities

Verify eligibility and benefits to determine coverage and payer requirements.
Ensure benefit information is entered correctly to reduce rework and support clean claims.
Gather clinical documentation supporting medical necessity for Respiratory Health products.
Review clinical documentation for applicable prescription, face-to-face, and coverage criteria requirements.
Prepare and submit prior authorization requests to commercial and government payers, including Medicare and Medicaid.
Process payer authorization decisions promptly to streamline operations and drive revenue.
Negotiate payment rates for letters of agreement to maximize collection potential.
Discuss payer policies, coverage criteria, benefit limitations, potential costs, and relevant product information with patients and healthcare teams to provide a strong customer experience.
Follow Baxter and third-party payer policies to maintain quality and compliance.
Contribute to team goals and understand how they support organizational goals.
Seek additional experience and knowledge across functional areas and perform other assigned duties and projects.