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Medical Records and Authorization Specialist

$50k - $53k

BioLife Plasma Services

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. 

You Role at Baxter

Perform Medical Records and Authorization Specialist duties including documentation collection and review, prior authorization and reauthorization submissions, The Medical Records and Authorization Specialist communicates directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies as well as collaborating cross-functionally with other Cardiology Health teams to coordinate in our mission of Saving and Sustaining Lives.

What You'll Do:

  • Ensure coverage and payer requirements.

  • Gather clinical documentation to support medical necessity for Cardiology devices.

  • Process paper and electronic correspondence, including logging and distribution of payer and patient inquiries.

  • Establish and maintain positive partnerships with sales team and healthcare teams.

  • Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met.

  • Prepare and submit prior authorization initial and renewal requests to all insurance companies including.

  • Process authorization decisions from payers timely to streamline and drive revenue.

  • Identify payer trends and establish payer-specific strategies to overcome reimbursement challenges.

  • Provide superior customer experience by leveraging the ability to discuss payer policies, coverage criteria, 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.

  • Actively seek additional experience and knowledge across all functional areas to gain expertise.

  • Provide workload coverage as needed.

  • Perform other duties and projects as assigned.

What You'll Bring:

  • High school diploma or equivalent required, Associates degree or higher preferred

  • 3+ years of industry experience in health insurance

  • Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations

  • Third party payer experience strongly preferred.

  • Experience in reviewing medical records and obtaining third-party payer reimbursement.

  • 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

Baxter is committed to supporting the needs for flexibility in the workplace. We do so through our flexible workplace policy which includes a minimum of 3 days a week onsite. This policy provides the benefits of connecting and collaborating in-person in support of our Mission.

We understand compensation is an important factor as you consider the next step in your career. At Baxter, we are committed to equitable pay for all employees, and we strive to be more transparent with our pay practices. The estimated base salary for this position is $49,600 - $53,000 annually. The estimated range is meant to reflect an anticipated salary range for the position. We may pay more or less than of the anticipated range based upon market data and other factors, all of which are subject to change. Individual pay is based on upon location, skills and expertise, experience, and other relevant factors. This position may also be eligible for discretionary bonuses. For questions about this, our pay philosophy, and available benefits, please speak to the recruiter if you decide to apply and are selected for an interview. ​

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time.

US Benefits at Baxter (except for Puerto Rico)

This is where your well-being matters. 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. Join us and enjoy the competitive compensation and benefits we offer to our employees. For additional information regarding Baxter US Benefits, please speak with your recruiter or visit our Benefits site: Benefits | Baxter

Equal Employment Opportunity

Baxter is an equal opportunity employer. Baxter evaluates qualified applicants without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, protected veteran status, disability/handicap status or any other legally protected characteristic.

Reasonable Accommodations

Baxter is committed to working with and providing reasonable accommodations to individuals with disabilities globally. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application or interview process, please click on the link here and let us know the nature of your request along with your contact information.

Recruitment Fraud Notice

Baxter has discovered incidents of employment scams, where fraudulent parties pose as Baxter employees, recruiters, or other agents, and engage with online job seekers in an attempt to steal personal and/or financial information. To learn how you can protect yourself, review our Recruitment Fraud Notice .

Vacancy posted more than 2 months ago
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