Reimbursement Coordinator

Job Description

Our client is seeking a highly motivated and detail-oriented Reimbursement Specialist / Coordinator with experience in the laboratory industry, preferably within start-up environments, to support their growing Billing and Market Access team. The ideal candidate has a strong understanding of reimbursement processes, payer policies, and healthcare data analysis. This role plays a key part in optimizing patient access, facilitating billing and reimbursement processes, and generating actionable insights from reimbursement data.

Responsibilities

• Serve as the subject matter expert on reimbursement strategies for our product(s), including medical benefit verification, prior authorizations, coding, appeals, and denials.
• Analyze reimbursement data and KPIs to identify trends, gaps, and opportunities for process optimization.
• Collaborate cross-functionally with Commercial, Medical Affairs, Compliance, and Finance to inform decision-making and streamline access operations.
• Monitor changes in payer coverage, CMS guidelines, and coding updates that may impact product reimbursement.
• Support the development of patient access programs and reimbursement in collaboration with Market Access and Customer Service.
• Assist in training team members in reimbursement processes and best practices.
• Utilize data visualization tools (e.g., Excel, Tableau,) and RCM systems to track, report, and communicate reimbursement metrics.

Required Qualifications

Preferred Qualifications