Reimbursement Specialist

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 BaxterTHIS IS WHERE you build trust to achieve results…As a Reimbursement Specialist, you will be responsible for duties in an 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 other Respiratory Health teams to coordinate in our mission of enhancing outcomes for patients and their caregivers.What you'll be doingPerform 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 Respiratory Health 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 MedicaidProcess 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.Actively seek additional experience and knowledge across all functional areas to gain expertise and perform other duties and projects as assigned.What you'll bring3+ years of industry experience, preferably in health insurance and/or durable medical equipmentThird party payer experience strongly preferred.Exceptional written, verbal, and interpersonal communicationsStrong critical thinking and problem-solving skillsDetail 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 SoftwareExperience with Total Information Management System (TIMS) a benefit.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 $41,600 to $57,200 annually. The estimated range is meant to reflect an anticipated salary range for the position. We may pay more or less than the anticipated range based upon market data and other factors, all of which are subject to change. Individual pay is based upon location, skills and expertise, experience, and other relevant factors. 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.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 | BaxterEqual Employment OpportunityBaxter 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.Know Your Rights: Workplace Discrimination is IllegalReasonable AccommodationsBaxter 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 NoticeBaxter 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.