Reimbursement Operations Coordinator jobs in United States
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Koya Medical, Inc. · 12 hours ago

Reimbursement Operations Coordinator

Koya Medical, Inc. is a transformative healthcare company developing breakthrough treatments for venous diseases and lymphedema. The Reimbursement Operations Coordinator plays a vital role in supporting the daily operations of the Prior Authorization and Appeals teams, facilitating communication with payers and patients, and ensuring timely processing of authorizations and appeals.

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Responsibilities

Communicate with payers to follow up on statuses of prior authorizations or appeals
Communicate with the team members about authorization and appeal statuses
Submit additional information to payers if needed for processing of authorization or appeal requests
Process approvals and denials accurately in salesforce
Explain appeal process to patients and obtain additional information needed for appeals such as personal attestation letters or payer specific forms
Communicate with clinician offices to obtain medical records, required documentation and signatures that are needed to assist with the authorization and appeal processes
Assist the department with dispersing correspondence
Maintain a high level of accuracy while meeting productivity and quality requirements
Support other departments to ensure accurate processing of patient orders and payer approvals and denials
Identify trends for process improvement and communicate to leadership
Assist in the development of internal processes and best practices for the reimbursement operations department
Benefit and authorization process investigation
Follow all compliance and HIPAA requirements
Other duties as assigned

Qualification

Healthcare reimbursementInsurance processesSalesforce CRMCommunicationProblem solvingAttention to detailTechnology savvyTeam collaborationFlexibilityCritical thinking

Required

High school diploma or equivalent, Associate's or Bachelor's degree a plus
Previous experience in the medical device industry, healthcare reimbursement or related field
Excellent written and verbal communication skills
Excellent problem solving and analytical skills
Ability to produce grammatically accurate authorization, appeal and patient correspondence
High attention to detail
Ability to work under pressure and deliver complete, accurate, and timely results
Proven ability to work independently, multitask, prioritize and meet required deadlines
Ability to be persuasive and credible with payers
Working knowledge and expertise of insurance processes
Technology savvy and able to navigate payer portal systems
Ability to work independently and in collaboration with a team
Able to provide clear and concise communication to payers, field reps, clinicians, peers and management via phone, email, video conference and/or in person

Benefits

Base + bonus compensation package
Competitive benefits program

Company

Koya Medical, Inc.

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Koya Medical is a transformative healthcare company developing breakthrough treatments for venous and lymphatic diseases to increase movement, mobility and personalized care that is unavailable with traditional compression therapy.

Funding

Current Stage
Growth Stage
Total Funding
$70.22M
Key Investors
OrbiMed3×5 PartnersArboretum Ventures
2023-11-15Series C· $30M
2022-02-03Series B· $26M
2021-01-14Series A· $11M

Leadership Team

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Damian Rippole
Chief Operating Officer & Financial Officer
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Company data provided by crunchbase