Reimbursement Specialist

Job Description:

Monitor, assess, and report on provider, payor, and legislative trends and developments. Manage day-to-day reimbursement activities to achieve key business objectives. Maintain existing reimbursement services and develop new ones. Work cross-functionally with Ossur’s Upper Limb sales organization and to develop new reimbursement services and training to targeted customers. Increase customer recognition of Ossur as a provider of industry-leading reimbursement resources.

Responsibilities:

• External Customer Reimbursement Responsibilities

  • Provide appropriate support to external customers with reimbursement questions about Ӧssur products.

  • Develop appropriate reimbursement materials regarding Ӧssur products for customers.

  • Assess and implement new reimbursement programs/resources/services that support Ӧssur’s customers.

  • Assist customers in obtaining authorization and writing appeals

• Internal Customer Reimbursement Responsibilities

  • Update Ӧssur Upper Limb Sales & Marketing staff re. changes in payor policies affecting our customers’ access to Ӧssur products.

  • Work cross-functionally with Ӧssur product management re. reimbursement issues / submissions to government contractors (e.g., PDAC).

• Other Responsibilities

  • Participate in DME MAC Advisory Council meetings.

  • Attend DME MAC educational meetings.

Company Responsibilities:

• Exercise good use of company funds and property within the set guidelines. Maintain an honest and professional attitude as the company’s representative at all times.

• All employees must be aware, have knowledge and shall have received general training in Ӧssur’s Quality requirements. Training takes place in the Onboarding process and in New Employee Orientation. More specific Quality training is job specific.

• All training related to the quality management system is done in accordance with the Training Management Process (QM1681).

• Contribute to a safe working environment by maintaining own workspace and reporting any potential hazards.

• Adhere to Company’s safety rules

• Adhere to Company Values – Honesty – Frugality – Courage

Qualifications:

• 5+ years of experience in medical device reimbursement, market access, reimbursement policy, healthcare provider, and/or healthcare payer

• BS/BA degree

• Strong understanding and working knowledge of private, federal, and state healthcare coverage

• Prior experience with O&P facilities and/or physician practices preferred, Upper Limb experience preferred

• Ability to review medical records and assess their compliance with payer coverage requirements

• Proven ability to work cross-functionally in a large organization

• Demonstrated ability to take initiative and seek guidance when appropriate

• Demonstrated strong written and oral communication skills in group and one-on-one settings 

• Strong analytical skills required

• Computer skills required, including Outlook, Word, Excel, and PowerPoint

• Ability to travel: 20%

• Remote work arrangement negotiable

Physical Requirements:

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.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel; and reach with hands and arms. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.

The US base salary range for this full-time position is $66,717 - $98,887 + bonus + benefits. Our salary ranges are determined by role, level, and location. The range displayed on each job posting reflects the minimum and maximum target for new hire salaries. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. Your recruiter can share more about the specific salary range for your preferred location during the hiring process.

Please note that the compensation details listed in US role postings reflect the base salary only, and do not include bonus, equity, or benefits.

Össur is a leading global provider of prosthetics and bracing and supports solutions.

Important Warning: Beware of fraudulent recruiters impersonating our company. Please take extra caution when asked for any sensitive personal information, such as social security numbers or bank account details. We will never ask you for any form of payment during the recruitment process. Please make sure you refer to our official website.