Reimbursement Manager

At Advanced Neuromodulation Systems, our goal is to improve the quality of life for the millions of people around the world who suffer with disabling pain or nervous system disorders. At the same time, we are committed to building a world-class company that offers significant and sustained value for our shareholders. We accomplish this mission through our people—a cadre of exceptionally talented individuals who genuinely care about improving patient outcomes, and who work together to develop leading-edge technology and services. The Reimbursement Manager - Central Area is home based and can be located anywhere in the central area.  Responsible for maintaining key strategic relationships between Marketing, Clinical and Sales Management. Provides expertise in understanding the reimbursement landscape related to Medicare, managed care customer and reimbursement/legislative changes that could impact existing and future products. Responsible for monitoring payer coverage and payment policies for assigned ANS and competitor products in the defined therapeutic area and across the assigned Medicare Regional Carriers and Fiscal Intermediaries; identifying relevant regional/local health care coverage opportunities and threats; and researching and resolving reimbursement issues identified by the customers and/or ANS sales/account teams. The Reimbursement Manager will be an expert in local and regional private/government payer policies and will assist existing and emerging customers in all aspects of billing and coding to ensure that patients are provided easy access to company products.  Experience & Training:   Bachelor of Science degree or equivalent experience. Minimum 3-5 years healthcare coding, coverage and reimbursement experience with medical device, pharmaceutical or biotechnology industries. Must have previous experience working with billing and medical claims personnel in various healthcare settings including, but not limited to physicians’ offices, hospitals and ambulatory surgery centers. Must have proven expertise in medical coding, billing processes and claim submissions to public and private insurers for biotechnology products, medical devices and pharmaceuticals. Familiarity with appropriate coding terminology and processes (CPT, HCPCS, ICD – 9, Revenue Codes, DRG etc), coverage and reimbursement. Must possess the ability to review health insurance forms (UB-92, CMS-1500, Explanation of benefits, prior authorization of forms, etc), and provider encounter forms (superbills/charge tickets) to troubleshoot cases where billings, claims submission or documentation errors may occur. Must have strong understanding of Medicare Part A & B, and legislative/policy issues as it relates to reimbursement. Excellent interpersonal and communication (oral and written) skills, and computer proficiency. Excellent problem-solving and project management skills. Demonstrated teamwork in a cross-functional setting. Self-directed; ability to work independently Demonstrated affinity for handling reimbursement issues with customers. Ability to successfully interact with key influencers and develop relationships outside of the normal peer selling environment. Ability to travel extensivelyQualified candidates may apply online via our website at http://www.sjm.com/ and reference position # ANS1152.  No agencies or phone calls, please. St. Jude Medical is an equal opportunity employer. We value a diverse workforce across all spectrums, including opinion and experience. We seek out creative, conscientious, confident individuals who thrive on taking initiative. In return for those qualities, we offer outstanding compensation, comprehensive benefits and opportunities for professional growth.