We have unique opportunities and are always looking for exceptional talent. Join a company where you will have an opportunity to grow professionally and personally and give strength to others by Empowering Healing. We offer a strong benefits package, opportunities for growth, and the chance to contribute to our mission: to provide an integrated portfolio of healing solutions that improve lives while lowering the overall cost of health care.

The Team Lead reports to the Reimbursement Supervisor.

JOB RESPONSIBILITIES:

• Investigate patients' medical benefits and identify opportunities for prior authorizations
• Monitor performance of others and assist with team training
• Exercise considerable latitude in setting functional priorities and assigning resources accordingly
• Prepare and submit prior authorizations in a timely manner
• Effectively interface with hospitals, wound care centers and physicians to insure the highest level of reimbursement is attained
• Communicate and accurately document payer trends
• Foster partnerships with national accounts
• Monitor and update Medicare, Medicaid and Private Pay or policies and guidelines
• Monitor and communicate policy developments that impact the reimbursement success of products
• Help build relationships in key markets with government, physician, hospital, and third-party payer decision makers
• Consistently complete 20-24 reimbursement cases
• Train new hire team members
• Assist with call monitoring
• Lead conference calls independently
• Participate in training of sales representatives including role play and shadow training
• Utilize technology and resources available to reimbursement team to minimize calls to the provider
• Consistently achieve 100% accuracy on audits and coach team members to enable them to achieve this goal
• Consistently produce the highest quality of work
• Demonstrate a strong understanding of payer policies and how to leverage this knowledge and support the business
• Cultivate a strong working relationship and exchange information with key opinion leaders in medical practices, internal customers, professional medical organizations and affiliated industry groups
• Effectively analyzes complex reimbursement data and make appropriate recommendations
• Seek and accept challenging tasks to learn and develop competencies
• Deliver World Class Service to all internal and external customers
• Look for ways to reduce errors and lower costs
• Follow all reimbursement internal processes
• Effectively handle and resolve conflicts
• Other duties as needed

Preferred Education and Experience:

• Medical device or biologics experience preferred
• BA/BS degree in Healthcare Administration, Business or Economics preferred
• 10 years of work experience in the health care industry preferred
• Medical device or biologics experience preferred
• Functional expertise in reimbursement and health care policy required
• An intimate knowledge of Medicare, Medicaid, Managed Care and Private Payer reimbursement processes required