Overview

The Medicare Specialist is responsible for ensuring Medicare criteria is met for claim submissions.

Responsibilities

• Review medical record and checklist documentation for specific criteria to satisfy Medicare’s medical necessity requirements
• Serve as an expeditor/liaison between Tactile Medical, clinicians, healthcare teams, and patients to obtain all necessary paperwork to drive order to closure
• Collaborate with pertinent internal departments to ensure successful Medicare submissions
• Maintain and/or exceed department service levels including turnaround time
• Be a team player. Assist other team members when needed
• Be a champion for continuous process improvement. Ask questions and continually look for ways to make processes better, faster or more efficient
• Contribute to monthly 1:1, small and large group team meetings
• Participate in training of new team members or field reps, handle product conversions and/or general account support
• Maintain compliance with all regulatory requirements including HIPAA
• Other duties as assigned

Qualifications

Education & Experience

Required:

• Bachelor’s degree or equivalent work experience
• 2 years of experience in medical device or health care reimbursement

Preferred:

• Previous experience with third-party payer regulations and processes, with emphasis on Medicare

Knowledge & Skills

• Understanding of Medicare methodologies (coding, coverage, clinical criteria, payment)
• Proficiency working with Microsoft Word, Excel, Teams and Outlook with the ability to navigate multiple systems
• Strong aptitude for learning systems and understanding processes quickly
• Exhibit excellent grammar, verbal and written communication skills
• Strong critical thinking skills
• Proven track record of building effective relationships with stakeholders
• Strong collaborative style, both internally and externally, to ensure objectives are met
• Results driven and proactive
• Thrives in a team environment but is also self sufficient
• Strong ability to multi-task and prioritize
• Passionate and eager to learn new skills
• Ability to adapt to an ever-changing environment
• Receptiveness to feedback
• Consistent follow up skills

Competencies

• Organization
• Teamwork
• Action Oriented
• Communication
• Documentation
• Process Management
• Priority Setting
• Peer Relationships
• Problem Solving

Below is the salary range for this position, although offers may differ based on the candidate’s location, job-specific knowledge, skills, and experience.

$23.41 - $35.10 / HR

Additional benefits:

Non-Exempt - Our total compensation package includes medical, dental and vision benefits, retirement benefits, employee stock purchase plan, paid time off, parental leave, family medical leave, volunteer time off and additional leave programs, life insurance, disability coverage, and other life and work wellness benefits and discounts. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.