Market Access Specialist

: Market Access Specialist

POSITION SUMMARY

ESSENTIAL FUNCTIONS OF THE POSITION

• Provide exceptional and timely customer service and follow-up internally and externally to support patient access.
• Support the reimbursement team on patient access and related market access issues.
• Provide guidance to customers and other stakeholders on coverage related to the company's products to facilitate coverage by Medicare, Medicare Advantage and Medigap carriers.
• Establish relationships with stakeholders to implement strategies, education, and the identification of coverage opportunities.
• Collaborate with stakeholders to research, troubleshoot, and resolve coverage issues.
• Provide continual evaluation of processes and procedures; develop methods to increase efficiency and productivity through improved processes and additional technology.
• Prioritize conflicting needs; handle matters expeditiously and proactively; have a process for follow up communication/escalation to ensure deliverables are met.
• Ensure compliance with regulatory requirements and company policy related to patient confidentiality (HIPAA) and customer interaction.
• Develop tools and analytics to support the organization's strategic objectives and organizational goals.
• Train new market and patient access staff with a focus on rapidly getting new employees to a high quality, full productivity level.
• Maintain and increase professional and technical knowledge by on-the-job training, attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.
• Support compliance with the company quality standards, FDA regulations and guidance, applicable EU Medical Device directives, applicable ISO standards, and other pertinent country specific medical regulatory requirements.
• Perform special projects and other duties as assigned.

EDUCATION AND/OR EXPERIENCE

Required

• Bachelor's degree in relevant field or equivalent combination of education and experience.
• A minimum of three years' prior-authorizations, coverage, medical billing, reimbursement, coding, coverage, payment or other relevant experience.
• Proficiency in HIPAA compliance.
• Strong knowledge of Medicare, Medicare Advantage, Medigap and private/commercial payer reimbursement methodology.
• Extensive understanding of the evolving healthcare landscape in the US.
• Broad understanding and prior experience working in the health care insurance industry, interfacing with health care insurance carriers including prior-authorizations, denial resolution and/or healthcare billing/revenue management.

Bonus

• Experience with Salesforce CRM.
• Medical device industry knowledge and familiarity.

SKILLS, ABILITIES, AND CHARACTERISTICS

• Passion to deliver an exceptional customer service experience to all internal and external customers.
• Superior professionalism and judgment balanced with a tenacious drive in order to assist the customer in achieving reimbursement.
• Analytically focused with a high attention to detail.
• Strong written and verbal communication, presentation, and negotiation skills, including presenting to leadership, sales, and physician/hospital customers.
• Ability to be nimble, adaptable, and independently carry-out and balance multiple responsibilities concurrently with the aptitude to anticipate and prioritize needs/workflow.
• Ability to understand assignments and complete them with little to no follow up from manager.
• Proactive with strong follow-up and organizational skills.
• Tech savvy: advanced in Microsoft Office applications, particularly MS PowerPoint and Outlook, and in mobile/cloud resources including CRM software (preferably Salesforce); comfortable learning new technical systems as needed such as Box, Zoom, Slack, Smartsheet, and Concur.

PHYSICAL REQUIREMENTS/WORK ENVIRONMENT

• Travel (Distributed Workforce) - Approximately 10% of time will be spent traveling to headquarters for team meetings, conferences, or meetings.
• Physical Demand - While performing the duties of this job, the employee is regularly required to stand, walk, and sit for extended periods of time. Physical effort required by handling objects of 25 pounds or more occasionally and/or up to 10 pounds frequently. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus in relation to travel and operating a personal computer. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Mental Demand - Moderate to high degree of concentration due to volume, complexity, and/or “pressure” of work. Ability to make critical thinking skills decisions under pressure.

• Work Environment -

• When working in a home office environment, a dedicated office with minimal distractions which assures maximum privacy of computer screens to protect confidential and sensitive information is required; highspeed internet connectivity is required to work effectively.

• Medical
• Dental
• Vision
• Basic Life and AD&D
• Supplemental Life & AD&D
• Long-Term Disability
• Health Care and Dependent Care Flexible Spending Accounts (FSAs)
• Health Savings Accounts (HSAs) with employer contribution

• Paid Time Off
• Paid Holidays
• Jury/Witness Duty Leave
• Bereavement Leave
• Parental Leave Salary Continuation
• Short-Term Disability Salary Continuation

• 401(k) Retirement Savings Plan with employer match
• Employee Assistance Program
• Voluntary Accident, Critical Illness, Hospital Indemnity and Legal
• Access to BenefitHUB discounts for 200,000 + vendors