Reimbursement Access Specialist

Position Summary

The Reimbursement Access Specialist is a highly visible, front-line position that reports to the Sr. Manager, Reimbursement Access and supports members of the Reimbursement Department to assist in the execution of the department’s strategic plan. This position may interact directly with key management personnel, internal and external customers, KOLs and providers to assure maximum reimbursement and eliminate reimbursement barriers. The appropriate candidate relies on experience and judgment to plan and accomplish goals. Key areas of focus include triaging customer and sales team inquiries, assisting the Sr. Manager, Reimbursement Access and Regional Reimbursement Managers with identified projects, coordinating meetings and disseminating information on reimbursement for Teleflex products. S/he will be instrumental in supporting and assisting the Reimbursement Team with payer relations and communications. This position answers questions and provides assistance to customers and the sales force for insurance claim processing and appeals.

Principal Responsibilities

•    Direct customer interface
•    Identify trends in customer communications
•    Respond as needed to coding, coverage, payment and billing questions from internal and external customers
•    Disseminate appropriate reimbursement tools as necessary to internal and external customers
•    Support the claims and appeals process including the tracking of claims and appeals
•    Create reports as requested
•    Refer complex reimbursement issues to the appropriate Regional Reimbursement Manager
•    Help to identify and facilitate physician/customer/patient advocacy for coverage initiatives

•    Support the Sr. Manager, Reimbursement Access
•    Assist in the development and management of timelines for key department initiatives
•    Manage vendor projects: Work within approved project and budget plans, consulting agreements and within Teleflex policies to complete projects according to established timelines.
•    Work with Reimbursement Department and Marketing Department to maintain Teleflex website with up to date reimbursement tools and information.
•    Provide reimbursement materials to customers, sales team and reimbursement personnel as needed
•    Coordinate internal and external reimbursement communication and develop tools for internal and external customers.
•    Monitor Medicare and private payer websites for policies relevant to Teleflex products and maintain a database of these policies
•    Oversee payer database
•    Assist in the coordination of payer meetings as needed
•    Support the development and implementation of training programs
•    Maintain reimbursement tools and materials
•    Maintain inventory of reimbursement tools
•    Support the development of reimbursement tools including internal review process
 

Specialized Skills / Other Requirements

The pay range for this position at commencement of employment is expected to be between $80,000 - 85,000 however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.  The total compensation package for this position will also include benefits such as medical, prescription drug, dental and vision insurance, flexible spending accounts, participation in 401(k) savings plan, and various paid time off benefits, such as PTO, short- and long-term disability and parental leave, dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
 
If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
 

Working Conditions / Physical Demands

TRAVEL REQUIRED: 25 %

WORKING ENVIRONMENT:
☒ Office/Professional        ☐ Plant/Manufacturing    ☐ Remote/Field     ☐ Laboratory