Senior Reimbursement and Market Access Specialist (Remote)

Stryker•Redmond, WA

3d•Remote

About The Position

As a Senior Market Access and Reimbursement Specialist, you will support the day-to-day reimbursement inquiries from the field sales representatives and physician, Ambulatory Surgical Center (ASC) , and hospital customers related to Interventional Spine (IVS) procedures. In this role, you will also review and support the periodic updates of coding documentation to ensure the accuracy of CPT, HCPCS, and ICD-10 coding. Additionally, you will conduct in-depth research on coding, coverage, and payment policies to effectively respond to customer and salesforce inquiries Serves as point of contact for complex reimbursement inquiries, working with cross-functional teams to resolve issues. Works closely with sales, marketing, patient access, and market access teams to ensure alignment on reimbursement strategy and execution. Collaborates with customers to research, troubleshoot and resolve claim issues and reimbursement challenges. Provides support in the prior authorization, denial and appeals process to providers, clinical, office staff and salesforce to include site visits as needed. Communicates with clinical and office staff, providers and salesforce regarding any missing, incomplete, or inconsistent documentation and to obtain accurate billing codes as necessary. Assists with the deployment of payer and provider focused communications regarding the value of Stryker IVS products Manages all aspects of the Coding Hotline and Email contacts, responding to inquiries as needed, track and trend data related to contacts reporting information. Accurately follows Stryker HIPAA policies, guidelines and legal requirements to ensure compliance.

Requirements

Bachelor's degree plus 2 years of relevant experience or associate's degree plus 6 years of relevant work experience or 8 years of relevant work experience plus a high school diploma.

Nice To Haves

2+ years of experience in providing coding, coverage, and payment advice in a healthcare setting
2+ years of experience with prior authorization, denials and appeals process
2+ years of experience of coding guidelines, medical procedures and services to appropriately review OP reports/notes, rejected claims and EOBs
2+ years of experience working with Medicare, Medicare Advantage, Medigap and private/commercial payer methodologies
CPC (Certified Professional Coder through American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information Management Association) is preferred.

Responsibilities

Support the day-to-day reimbursement inquiries from the field sales representatives and physician, Ambulatory Surgical Center (ASC) , and hospital customers related to Interventional Spine (IVS) procedures.
Review and support the periodic updates of coding documentation to ensure the accuracy of CPT, HCPCS, and ICD-10 coding.
Conduct in-depth research on coding, coverage, and payment policies to effectively respond to customer and salesforce inquiries
Serves as point of contact for complex reimbursement inquiries, working with cross-functional teams to resolve issues.
Works closely with sales, marketing, patient access, and market access teams to ensure alignment on reimbursement strategy and execution.
Collaborates with customers to research, troubleshoot and resolve claim issues and reimbursement challenges.
Provides support in the prior authorization, denial and appeals process to providers, clinical, office staff and salesforce to include site visits as needed.
Communicates with clinical and office staff, providers and salesforce regarding any missing, incomplete, or inconsistent documentation and to obtain accurate billing codes as necessary.
Assists with the deployment of payer and provider focused communications regarding the value of Stryker IVS products
Manages all aspects of the Coding Hotline and Email contacts, responding to inquiries as needed, track and trend data related to contacts reporting information.
Accurately follows Stryker HIPAA policies, guidelines and legal requirements to ensure compliance.