US-CA-Redwood CityJob Post Information* : Posted Date
14 hours agoCategory
SalesMore information about this job:About Nevro Nevro is a medical device company headquartered in Redwood City, California. We have developed HF10™ therapy, an innovative, evidence-based neuromodulation platform for the treatment of chronic pain.We started with a simple mission to help more patients suffering from chronic pain. At each stage of development, our research was subject to the highest levels of scientific rigor, resulting in a new therapy that has advanced the state of spinal cord stimulation (SCS).We explored beyond traditional SCS frequencies (40-60 Hz) in search of better therapeutic outcomes. Combining high frequency at 10 kHz with a unique waveform and a specific treatment algorithm resulted in HF10 therapy: a paresthesia-free treatment proven to provide more pain relief to more patients in more pain areas.1The Nevro® Senza® SCS System received CE mark in 2010, TGA approval in 2011, FDA approval in 2015, and is commercially available in Europe, Australia, and the United States.Overview Reporting to the Reimbursement Operations Manager, the Patient Access Specialist will focus on providing market access support to customers through prior authorization, appeals support, detailed claims review and reimbursement hotline support. The Patient Access Specialist will be responsible for providing reimbursement expertise and support regarding all phases of the prior authorization process, appeals and all related market access activities with all types of customers. The Patient Access Specialist will be responsible for providing excellent customer service and follow-up on all assigned work. The Specialist will also be responsible for meeting quality metrics to ensure quality service to all customer types. Role Requirements
Skills and Knowledge
- Bachelor's Degree (health economics, life sciences, public health, public policy, finance, business or marketing disciplines) or equivalent work experience.
- 5+ years medical billing or prior authorization experience.
- The Patient Access Specialist will adhere to quality of NevroCare service through QA, additional training and process improvement.
- Work in conjunction with the Manager to focus on realistic and achievable turn-around times for all department functions.
- Meet and/or exceed metrics in designated territory to ensure quality service to all customer types.
- Provide necessary documentation and follow up in order to support the prior authorization and appeal process as well as provide education to customers regarding payer coverage requirements.
- In conjunction with other team members, stay current on payer coverage policies and patient requirements for HF10 therapy as well as stay current on impact of health care reform to patient's access to HF10 therapy.
- Ensure compliance with company compliance policy, in particular patient confidentiality (HIPAA) in all NevroCare practices.
- Perform other duties as required
- Experience complying with regulatory requirements and company policy in dealing with the customer and patient confidentiality.
- Applicable experience in reimbursement support relating to appeals and prior authorizations from a payer, provider or medical device/pharmaceutical industry.
- Ability to work with various teams to accomplish organizational goals.
- Excellent communication skills, both verbal and written.
- Analytically focused with a high attention to detail.
- Ability to follow work processes.
- Must be courteous, professional and balanced with a tenacious drive in order to assist the customer and NevroCare team in achieving goals.
- Able to multitask and prioritize workflows.
- Excellent organizational and project management skills.
- Strong interpersonal skills to influence/negotiate complex decisions and ability to demonstrate leadership as a positive advocate for communicating the mission, objectives and results of the NevroCare team and build cross-functional relationships.
Nevro offers equal employment opportunity, regardless of race, color, creed, religion, national origin, marital or family status, sex, sexual orientation, gender expression (including religious dress and grooming practices), gender (including pregnancy, childbirth or medical condition related to pregnancy or childbirth), physical or mental condition, disability, age or other characteristics protected by laws.