Summary
Our client, a Fortune 500 medical device company , has engaged GForce Life Sciences to provide a detail-oriented and knowledgeable Clinical Reimbursement and Pricing Specialist to support the pricing and contracting process by triaging and resolving lower- to mid-level pricing deviations and related issues. The ideal candidate will have 2–4 years of experience in reimbursement and coding, with a strong understanding of healthcare compliance and technical reimbursement processes.
Job Duties
· Review and address lower- to mid-level pricing issues that arise during the contracting process.
· Triage reimbursement-related inquiries and escalate complex cases as needed.
· Ensure compliance with federal, state, and industry reimbursement regulations.
· Apply knowledge of US reimbursement coding, including DRG assignments and APC categorizations.
· Interpret complex disease states and communicate related technical product information effectively.
Requirements
· 2–4 years of experience in healthcare reimbursement and coding.
· In-depth understanding of federal, state, and industry rules and regulations related to reimbursement and compliance.
· Proficient in DRG and APC methodologies.
· Ability to grasp and explain complex clinical information and product details.
Term & Start
· Contract through end of the year, possibility of converting FT
· Hybrid in Santa Clara, CA, Sylmar, CA, Maple Grove, MN, Plano, TX, or Burlington, MA
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