We are seeking a highly skilled and experienced professional to join our team as the MedTech Billing & Coding Contract Specialist. This role is essential in developing and implementing strategies that support billing, coding, and reimbursement processes across diverse healthcare settings, including hospitals today and midwifery practices and birth centers in the future.
The ideal candidate will possess deep expertise in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and Medicaid. The role will also support the development of a contracting strategy for the MedTech business.
Responsibilities
- Billing and Coding Acumen : Develop and enhance billing and coding knowledge across different settings of care, ensuring accurate and efficient physician billing.
- Reimbursement Expertise : Serve as an expert in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and Medicaid. Serve as an expert on DRG hospital and provider reimbursement.
- Customer Engagement : Provide customer-facing support to troubleshoot billing, coding, and reimbursement challenges, ensuring high levels of satisfaction and resolution.
- Contract Strategy Development : Lead the development of contracting strategies to optimize financial performance and compliance. Strong understanding of CMS rules, stark law, anti-kickbacks in medical device space. In addition, the role will support contract analytics and execution support efforts.
- Resource Development : Create and maintain reimbursement resources to support internal teams and external partners.
- Payer Marketing : Develop and implement marketing strategies to enhance payer relationships and reimbursement outcomes.
- Health Economics : Develop health economics strategies and resources with focus on reduction in healthcare costs, revenue cycle management, cost avoidance, and cost consequence analysis.
- Systems Expertise : proficiency in reimbursement and billing systems such as Epic and Cerner.
Required Education, Experience And Skills
Bachelor's degree in healthcare administration, business, or a related field (Master's preferred).Professional certifications suggest certified professional coder (CPC, certified revenue cycle representative (CRCR), or certified healthcare financial professional (CHFP) preferred.Extensive experience in billing, coding, and reimbursement processes.In-depth knowledge of inpatient and maternal health settings.Proven track record in strategy development and resource creation.Strong background in payor access, contracting, value-based modeling, and contract analytics.Experience in payer marketing and relationship management.Leadership : Demonstrated ability to lead and inspire teams to achieve strategic goals.Collaboration : Strong collaborative skills to work effectively with cross-functional teams and external partners.Customer Engagement : Excellent customer engagement skills to address and resolve billing and reimbursement issues.Analytics : Expertise in evaluating customer and contract performance data to identify and deliver recommendations to business leaders.Minimum of five (5) years of experience in a similar role within the healthcare industry.Strong analytical and problem-solving skills.Excellent communication and interpersonal skills.Ability to travel up to 25% of the time.Organon delivers ingenious health solutions that enable people to live their best lives. We are a $6.5 billion global healthcare company focused on making a world of difference for women, their families and the communities they care for.
Organon is an Equal Opportunity Employer. We are committed to fostering a culture of inclusion, innovation, and belonging for all employees and job applicants. We ensure all employment practices are conducted without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability, veteran status, or any other characteristic protected by state or federal law.
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