Medicare Specialist

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

Accountabilities & Responsibilities:

• Review medical records 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

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