Essity’s newly created business unit Health and Medical Solutions sells and markets purpose made incontinence products and services under the global leading brand TENA and develops, manufactures and sells products within wound care, compression therapy and orthopedics under the BSN medical and Leukoplast, Cutimed, JOBST, Delta Cast, Delta Lite and Actimove brands.
Our mission is "To empower consumers, patients and caregivers with products and solutions to support healthy and active lives".
We do this by understanding the needs of our target groups and develop and market products and services that make a positive contribution to their quality of life and well-being. The Global Medical Affairs Team is searching for a Reimbursement Specialist, HCPCS Level IIto work out of the Charlotte, NC office.
Demonstrate thorough expertise of HCPCS level II coding and provide guidance to the business to obtain appropriate reimbursement codes under Medicare and Medicaid
Coordinate required information from respective departments, for planned reimbursement applications and input into innovation projects
Compile PDAC submissions for new product launches as well as manage re-submissions for renewals and/or code changes
Govern the submission and verification process to facilitate professional and solution-oriented communication with the PDAC contractor
Build and maintain a data base to safeguard transparency and traceability of coding reviews and decisions, including PDAC letters, for products marketed in the U.S. by Essity and its affiliates, including BSN Medical Inc,
Ensure compliance with correct coding information on all information and advertising material for every product at each stage of their product life cycle
Keep abreast of regulatory changes related to coding and documentation, including competitive bidding, and communicate these changes proactively to position the organization for success
Manage denials of reimbursement applications by advising the business of the appropriate mitigation procedures and pursue appeals or re-submissions
Serve as counterpart for regular auditing processes to ensure products are appropriately coded and sold and marketed within the necessary boundaries
Support the business with reimbursement assessment of competitive products
Bachelor’s Degree or vocational certification related to the medical, life science, health information management or adjacent technical field required; Master’s degree preferred
Minimum 5 years proven track record in HCPCS Level II coding in the medical device industry, ideally with experience in orthopedics
AAPC certification as medical coder (CPC, COC) preferred
Strong skills in analytical and critical thinking, project management, writing, problem solving and communication.
Excellent written and oral communication skills to educate in his/her area of expertise in front of different target groups.
Experience with federal and state regulatory requirements, regulatory compliance, and billing requirements is a plus
Self-managed, organized, with ambition to achieve results with high perspective
Internal Number: 1
Essity is a leading global hygiene and health company dedicated to improving well-being through our products and solutions, essentials for everyday life. The name Essity stems from the words essentials and necessities. Our sustainable business model creates value for people and nature. Sales are conducted in approximately 150 countries under the leading global brands TENA and Tork, and other strong brands, such as Jobst, Leukoplast, Libero, Libresse, Lotus, Nosotras, Saba, Tempo, Vinda and Zewa. Essity has about 48,000 employees and net sales in 2017 amounted to approximately SEK 109bn (EUR 11.3bn). The headquarters is located in Stockholm, Sweden, and the company is listed on Nasdaq Stockholm. More information at www.essity.com.