• - Health Economics - Columbia
  • Columbia, MD, USA
  • Full Time

Title: Market Access and Reimbursement Specialist

Reports To: Director, Health Economics and Market Access

Location: Columbia, MD

Position Summary: The Market Access and Reimbursement Specialist will be responsible for supporting internal stakeholders and customers with coding and reimbursement expertise and contribute to overall market access strategy. The Specialist will provide internal training and field sales support, and answer questions from customers related to coding and reimbursement. He/she will also be responsible for conducting analyses of reimbursement scenarios for pipeline products and pursuing identified opportunities related to coding and reimbursement in collaboration with the HEMA Director. He/she will also be responsible for the development of materials (e.g., product coding and reimbursement guides) in collaboration with marketing colleagues and will work with other members of the Health Economics and Market Access team on value-related resources. If you are organized and thrive in a dynamic, fast-paced environment, then this role is for you.  

Essential Functions and Responsibilities:

  • Acts as internal expert and resource on coding and reimbursement for Ambu's single-use endoscopy product portfolio.
  • Communicate with sales representatives and customers to address coding and reimbursement questions and concerns, including occasional on-site customer meetings (post-pandemic).
  • Develop and provide training on coding and reimbursement topics to sales representatives and other internal stakeholders
  • Conduct systematic analyses of the reimbursement potential for our products/solutions to inform strategic decision-making in close collaboration with all relevant internal stakeholders.
  • Evaluate and pursue coding and reimbursement opportunities (e.g., new CPT codes, etc.) as appropriate.
  • Develop and/or update coding and reimbursement guides and other materials, working with the Marketing Communications team.
  • Collaborate with the Health Economics and Market Access team to develop tools and resources that may be used by sales representatives and other internal stakeholders.
  • Review and edit complex technical documents for clarity, grammar, spelling, punctuation, and consistency.
  • Up to 20% travel as needed, post-pandemic (i.e. customer meetings and industry events).

 Qualifications / Experience:

  • Bachelor's Degree in relevant field, e.g., Health Administration, Business, Nursing, Public Health, etc. Graduate degree preferred.
  • Minimum of four (4) years' experience in market access and reimbursement in the U.S.
  • Professional coding certification from a national organization (i.e., AAPC or AHIMA) preferred.
  • Knowledge of health insurance coding, coverage, billing, and reimbursement, inclusive of private commercial coverage and Medicare coverage.
  • In-depth understanding of payers and their value drivers in major markets as well as trends in pricing & reimbursement.
  • Knowledge of Medicare TPT and NTAP preferred.
  • Experience in the Medical device industry preferred.
  • Previous coding and billing experience in an office, hospital, ASC, or IDN setting preferred.
  • Experience collaborating and working with payers, existing relationships are preferred.
  • Strong clinical focus, business acumen, and ability to develop and build upon existing relationships.
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