The Lead Reimbursement Specialist ensures accurate reimbursement guidance and resolves coding/payment challenges through research and collaboration. Responsibilities include managing inquiries, supporting claims, and mentoring team members.
Work Flexibility: Remote
Make an impact with a team that empowers providers and patients. In this role, you will help ensure our customers receive accurate reimbursement guidance, enabling access to life‑changing IVS technologies. You’ll partner closely with sales, providers, and cross‑functional teams to turn complex coding and payment challenges into clear, actionable solutions.
What You Will Do- Support reimbursement inquiries from sales teams, providers, and customers by delivering accurate coding, coverage, and payment guidance within established service levels.
- Conduct in‑depth research on coding, payer policies, and regulatory updates to resolve complex reimbursement questions and inform internal decision-making.
- Review and update coding documents to maintain accuracy of CPT, HCPCS, ICD‑9, and ICD‑10 assignments.
- Manage all Coding Hotline and email inquiries, tracking and trending contact data to identify patterns and opportunities for improvement.
- Collaborate with providers to research, troubleshoot, and resolve claim issues, including prior authorization, denials, and appeals.
- Coordinate with Sales Representatives to deliver required documentation and ensure customer billing and reimbursement needs are met.
- Develop and deploy payer and provider communications that highlight the value of IVS products and support reimbursement education.
- Provide training, mentorship, and support to new and junior reimbursement team members to help accelerate their proficiency and performance.
- Bachelor’s degree and minimum 4 years of relevant experience, or
Associate’s degree and minimum 8 years of relevant experience, or
High school diploma/equivalent and minimum 10 years of relevant experience. - Extensive experience providing coding, coverage, and payment guidance in a healthcare environment.
- Extensive experience supporting prior authorization, denials, and appeals processes.
- Comprehensive knowledge of medical coding guidelines and ability to review operative reports, rejected claims, and EOBs.
- Comprehensive knowledge of Medicare, Medicare Advantage, Medigap, and commercial payer methodologies.
- CPC (Certified Professional Coder) or CCS‑P (Certified Coding Specialist – Physician).
$77,700 - $168,400 salary plus bonus eligible + benefits. Individual pay is based on skills, experience, and other relevant factors.
This role was posted on 2/12/26
Top Skills
Cpt
Hcpcs
Icd-10
Icd-9
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