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Reimbursement Specialist

https://www.baxter.com/ Logo

Baxter

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Location:
United States , Saint Paul

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Category:
-

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Contract Type:
Not provided

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Salary:

49600.00 - 68200.00 USD / Year

Job Description:

Perform Reimbursement Specialist duties for assigned territory or payer(s) including eligibility and benefit verification, documentation collection, prior authorization and reauthorization submissions, letter of agreement payment negotiations, and processing payer decisions. Communicate directly with patients, healthcare teams, and insurance companies as well as collaborating cross-functionally with teams to coordinate in our mission of enhancing outcomes for patients and their caregivers.

Job Responsibility:

  • Perform verification of eligibility and benefits to determine coverage and payer requirements
  • Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
  • Gather clinical documentation to support medical necessity for Cardiology products
  • Assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
  • Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
  • Process authorization decisions from payers timely to streamline and drive revenue
  • Negotiate payment rates for letter of agreement to ensure maximum collection potential
  • Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
  • Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance
  • Consistently contribute to team goals and understand how they support greater organizational goals

Requirements:

  • 3+ years of industry experience, preferably in health insurance and/or durable medical equipment
  • Third party payer experience strongly preferred
  • Exceptional written, verbal, and interpersonal communications
  • Strong critical thinking and problem-solving skills
  • Detail orientated and ability to multi-task
  • Ability to work independently as well as in a team environment
  • Possess the ability to manage time and prioritize critical priorities
  • Proficiency in Microsoft Office Software

Nice to have:

Experience with Total Information Management System (TIMS) a benefit

What we offer:
  • Medical and dental coverage that start on day one
  • Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
  • Employee Stock Purchase Plan (ESPP)
  • 401(k) Retirement Savings Plan (RSP)
  • Flexible Spending Accounts
  • Educational assistance programs
  • Paid holidays
  • Paid time off ranging from 20 to 35 days based on length of service
  • Family and medical leaves of absence
  • Paid parental leave
  • Commuting benefits
  • Employee Discount Program
  • Employee Assistance Program (EAP)
  • Childcare benefits

Additional Information:

Job Posted:
January 31, 2026

Employment Type:
Fulltime
Work Type:
Hybrid work
Job Link Share:

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