Reimbursement Specialist

Position Summary

Reporting to the Director, Global Reimbursement, the Reimbursement Specialist will play a vital role supporting projects related to expanding payer coverage, health economic analyses, monitoring healthcare policy trends, and interfacing with customers on various market access initiatives. Additionally, this role will help support the needs of the Patient Access team, HFX Access. The position is part of the Scientific Affairs department and will work in collaboration with various cross-functional partners including HFX Access, Field Sales, Marketing and Clinical Affairs.

Essential Functions

• Work with field-based sales team to provide reimbursement-related support (Coding, Billing, Payment, Medical Policy) to customers.
• Assist in providing internal training to sales team and customers, including launching new initiatives or programs.
• Track medical policy changes and other relevant policies that are applicable to Nevro products and pipeline and share with internal stakeholders.
• Monitor, review and analyze CMS' annual rulemaking and open meetings.
• Research and extract relevant information from secondary data sources to provide strategic insight into market access strategies.
• Interface with Patient Access team (HFX Access) as appropriate to assist with challenge resolution.
• Establish relationships with key institution/accounts associated with coding, billing, and reimbursement.
• Work cross-functionally with HFX Access, National Accounts, Marketing, Sales, Commercial Operations.
• Stay abreast of macro trends in the healthcare environment that potentially impact current and/or future product pricing, contracting and distribution.
• Adheres to the letter and spirit of the company Code of Conduct, the AdvaMed Code, MedTech Code, and all other company policies.
• Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role.
• Represents the company in a professional manner and uphold the highest standards of ethical business practices and socially responsible conduct in all interactions with other employees, customers, suppliers, and other third parties.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• At least 1-2 years' work experience in reimbursement or market access functions.
• Demonstrated working knowledge of the US healthcare system including coverage, coding, and payment policies by public and private payers.
• Travel expectation up to 10%.
• Patient access experience preferred.
• Strong written, verbal, and phone communication skills.
• Customer service / client relations required.
• Advanced Microsoft Excel skills including advanced formulas preferred.
• Demonstrated ability to develop and influence relationships.
• Great interpersonal skills and enjoy interacting with the sales team.
• Solid communication and oral presentation skills.
• Experience in other functions within the pharmaceutical, biotechnology or related industry is a plus, e.g., field sales, legal, market planning, market or sales analytics, etc.