Job Closed
This listing is no longer active.
Together with our customers, we are driven to make healthcare better. #WeAreStryker
Senior Reimbursement and Market Access Specialist (Remote)
Location
United States
Posted
89 days ago
Salary
$69.1K - $139K / year
Seniority
Senior
No structured requirement data.
Job Description
Senior Reimbursement and Market Access Specialist (Remote)
Stryker
Work Flexibility: Remote What you will do: As a Senior Market Access and Reimbursement Specialist, you will support the day-to-day reimbursement inquiries from the field sales representatives and physician, Ambulatory Surgical Center (ASC) , and hospital customers related to Interventional Spine (IVS) procedures. In this role, you will also review and support the periodic updates of coding documentation to ensure the accuracy of CPT, HCPCS, and ICD-10 coding. Additionally, you will conduct in-depth research on coding, coverage, and payment policies to effectively respond to customer and salesforce inquiries - Serves as point of contact for complex reimbursement inquiries, working with cross-functional teams to resolve issues. - Works closely with sales, marketing, patient access, and market access teams to ensure alignment on reimbursement strategy and execution. - Collaborates with customers to research, troubleshoot and resolve claim issues and reimbursement challenges. - Provides support in the prior authorization, denial and appeals process to providers, clinical, office staff and salesforce to include site visits as needed. - Communicates with clinical and office staff, providers and salesforce regarding any missing, incomplete, or inconsistent documentation and to obtain accurate billing codes as necessary. - Assists with the deployment of payer and provider focused communications regarding the value of Stryker IVS products - Manages all aspects of the Coding Hotline and Email contacts, responding to inquiries as needed, track and trend data related to contacts reporting information. - Accurately follows Stryker HIPAA policies, guidelines and legal requirements to ensure compliance. What you need: Required: - Bachelor's degree plus 2 years of relevant experience or associate's degree plus 6 years of relevant work experience or 8 years of relevant work experience plus a high school diploma. Preferred: - 2+ years of experience in providing coding, coverage, and payment advice in a healthcare setting - 2+ years of experience with prior authorization, denials and appeals process - 2+ years of experience of coding guidelines, medical procedures and services to appropriately review OP reports/notes, rejected claims and EOBs - 2+ years of experience working with Medicare, Medicare Advantage, Medigap and private/commercial payer methodologies - Licensure or Certification: CPC (Certified Professional Coder through American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information Management Association) is preferred. $69,100 - $139,600 salary plus bonus eligible + benefits. Actual minimum and maximum may vary based on location. This role was posted on 3/25/2026 Travel Percentage: 10% Stryker Corporation is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Stryker is an EO employer – M/F/Veteran/Disability. Stryker Corporation will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
Related Guides
Related Categories
Related Job Pages
More Medical Reviewer Jobs
RN Virtual Advanced Care
OSF HealthCareOSF HealthCare, a multi-state corporation based in Peoria, Illinois provides compassionate, innovative medical care to over 1.5 million people in the Illinois and Michigan areas. O
Total Rewards "Your life - our Mission" OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF. Pay range for this position is $34.25 - $51.13/hour. Actual pay is based on years of licensure. This is an Hourly position. Remote: this position is fully-remote after training and orientation are completed. Overview POSITION SUMMARY: The Registered Nurse Virtual Care is a member of a collaborative team who is responsible for providing virtual nursing care to a diverse population of patients across OSF through technology in their home environment. Provides proactive monitoring, prevention, early intervention and ongoing care with the goal to optimize quality of life for the patient at home through access to healthcare. Utilizes critical thinking, evidenced-based care and clinical decision support to guide practice. Performs ongoing communication and works to promote quality of care through collaboration with all care team members, patients and families. Acts as a patient advocate and resource to other health care providers. The RN demonstrates service excellence and accountability through recognizing the direct relationship between cost-effective and efficient provision of care and services including the impact of access to care. Remote: This position will be remote-working at the discretion of leadership after training and orientation are completed. Applicants must have an active RN IL license. Qualifications REQUIRED QUALIFICATIONS: - Education: Nursing Degree - Experience: 3 years of recent RN experience - Licensure/ Certification: RN licensure in IL required before hire, Michigan License required within 6 months of hire. - Other Skills/ Knowledge: Excellent interpersonal and communication skills. - Solid computer skills, including proficiency with Microsoft software. - Strong analytical and problem-solving skills, with the ability to be detail oriented. - Working knowledge of Windows based computer applications, electronic EMR, and digital communication platforms. PREFERRED QUALIFICATIONS: - Education: BSN - Experience: Ambulatory and Chronic Illness experience OSF HealthCare is an Equal Opportunity Employer.
Case Manager RN
Somatus, Inc.As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: Authenticity: We believe in real dialogue. Collaboration: We appreciate what every person at Somatus brings to the table. Empowerment: We make sure every voice gets heard and all ideas are considered. Innovation: We relentlessly look for ways to improve upon the status quo. Tenacity: We see challenges as opportunities for growth and improvement.
Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you? Showing Up Somatus Strong We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: - Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say. - Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more. - Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests. - Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions. - Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners. Showing Up for You We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including: - Subsidized, personal healthcare coverage (medical, dental vision) - Accrual of 3 weeks’ Vacation (PTO) - Professional Development, CEU, and Tuition Reimbursement - Curated Wellness Benefits supporting teammates physical and mental well-being - Community engagement opportunities - And more! This position is responsible for ensuring the continuity of care in both the inpatient and outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients’ health plan benefits. Facilitates continuum of patients’ care utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site or telephonically as the need arises. This is a fully remote role where compact licensure is strongly preferred. **The schedule for this position includes some evening hours where you will be expected to work until approximately 8pm, based on member availability. For example: 11am-8pm OR a split shift 8am-12pm and then 4pm-8pm** Responsibilities - Consistently exhibits behavior and communication skills that demonstrate our company's commitment to superior customer service, including quality, care and concern with each and every internal and external customer. - Prioritizes patient care needs upon initial visit and addresses emerging issues. - Virtually meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan telephonically. - Virtually identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings. - Consults with physician and other team members to ensure that care plan is successfully implemented. - Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members. - Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes. - Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management. - Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care. - Works in coordination with the care team and demonstrates accountability with patient management and outcome. - Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families. - Assist member to maximize benefits according to health plan. - Participates actively in assigned Care Management Coordination Committee (CMCC) meetings. - Documents pertinent patient information and Care Management Plan in Electronic Health Record and Care Management Systems as appropriate. - Coordinates care with larger interdisciplinary team on assigned patient caseload or panel. - Adheres to departmental policies and procedures. Qualifications Required Qualifications: • Active RN license in current state of residence with the ability to qualify for additional state licenses as requested • 2+ years of nursing experience in a hospital, acute care, or direct care setting • Renal, Chronic Kidney Disease or Dialysis Care experience as a main focus of your job • Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook), including the ability to type and talk at the same time while navigating a Windows environment • Access to dedicated workspace from home for in home office set up • Ability to work schedule listed • Reside in a location that can receive a high speed internet connection or can leverage existing high-speed internet service Preferred Qualifications: • BSN • Certified Case Manager (CCM) • Diabetic educator experience • ICU, Cardiology or Critical Care experience • Telephonic case management experience • Experience with discharge planning • Solid working knowledge of hypertension and/or diabetes Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated. IND1
OUR MISSION We exist to create a more connected, compassionate, and confident experience for people with cancer and those who care for them. We make it easier to get answers, access high-quality care quickly, and feel supported throughout treatment and beyond. Today, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for thousands of people across the country. Our model combines high-touch human support with powerful technology and AI to bring together everyone involved in a person’s cancer journey: caregivers, oncologists, health plans, and employers. As a tech-native organization, we believe technology should strengthen the human connection at the center of care. Through data science, automation, and AI, we simplify complexity, improve collaboration, and help care teams focus on what matters most: supporting people through cancer. Looking ahead, our vision is bold: to become a household name in cancer care, where every person diagnosed asks for Thyme Care by name. If you’re inspired to make cancer care more human and to help reimagine what’s possible, we’d love to meet you. Together, we can build a future where every person with cancer feels truly cared for, in every moment that matters. WHAT YOU’LL DO As the Comprehensive Health Assessment Nurse Practitioner, you will be a critical clinical team member caring for our members. You will conduct the first and annual clinical interaction with our members in this role. Using a telemedicine platform, this interaction will be a thorough, whole-person, comprehensive history and exam. You will evaluate risk scores and assess gaps in care. You will develop comprehensive care plans to address clinical and non-clinical needs and barriers. You will prioritize our members’ goals and create concrete plans for our Oncology Nurse Navigators and Community Health Workers to reach these goals. To do this, you will review available medical records, work with external providers, give clinical insights to our care team, and adhere to best documentation practices to drive high-quality care for our members. In addition to your primary responsibilities, you may be asked to participate in some holiday, night and weekend emergency coverage as needed. This role reports to our Nurse Practitioner Manager and can be remote or hybrid-based in our Nashville or New York City offices. All patient interactions will be virtual via telephone, video, text, or our proprietary virtual care platform. WHAT YOU’VE DONE Within your first three months, you will: - Complete training and be up to speed on Thyme Care’s systems, tools, technology, partners, and clinical expectations. - Be adept at developing evidence-based, member-centered care plans that will guide our Community Health Workers and Oncology Nurse Navigators in effectively prioritizing our members' needs and goals. - Complete whole-person history and physical assessments for our members with the highest clinical rigor. You’re working fluidly with our in-house care team and providers to ensure any identified needs are met in follow-up to patient visits. - Become the go-to person for our Oncology Nurse Navigators and Community Health workers when working with a member with complex and intersecting needs. - Be comfortable following policies, procedures, escalation pathways, communications best practices, and documentation standards. WHAT LEADS TO SUCCESS People-first. Thyme Care’s mission and members matter to you deeply. Experience. You have at least 3 years of NP experience, including 2 years in adult oncology and at least one year of telehealth experience. Experience completing health risk assessments is a plus! It would be exceptional if you have worked at a startup or tech-forward company. Licensure. You have a compact RN license, an unrestricted Advanced Practice license, and a willingness to obtain additional state licenses. Organized. You’re skilled in juggling multiple tasks and working under pressure without sacrificing organization in your communications and documentation. Effective listener and communicator. You are winsome and articulate, but you always start with listening and hearing what may not be voiced because you listen intently to others. You build rapport and excellent working relationships with members and colleagues. Comfort with ambiguity. Start-ups are fast-paced environments, and you understand that rapid changes to the business, strategy, organization, and priorities are par for the course… and part of the adventure. A desire to learn how to use new technologies. We are a technology company focused on interacting with folks during the season when they need it most. Experience with video chatting, Google Suite, Slack, electronic health records, or comfort in using and learning new technology is vital. Identify priorities and take action. You know how to identify and prioritize a member's needs and do what it takes to address urgent needs immediately. OUR VALUES At Thyme Care, our core values guide us in everything we do: Act with our members in mind, Move with purpose, and Seek diverse perspectives. They anchor our business decisions, including how we grow, the products we make, and the paths we choose—or don’t choose. Our salary ranges are based on paying competitively for our size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Thyme Care. Individual pay decisions are based on several factors, including qualifications, experience level, skillset, and balancing internal equity relative to other Thyme Care employees. The base salary for this role is 140,000. The salary range could be lower or higher than this if the role is hired at another level. We recognize a history of inequality in healthcare. We’re here to challenge the status quo and create a culture of inclusion through the care we give and the company we build. We embrace and celebrate a diversity of perspectives in reflection of our members and the members we serve. We are an equal-opportunity employer. Be cautious of recruitment fraud, and always confirm that communications are coming from an official Thyme Care email.
Behavioral Health - APP - Virtual Care (PRN 4/4)
UnityPoint HealthUnityPoint Health is a healthcare system whose coordinated approach to medical care serves patients across metropolitan and rural communities in Iowa and Illinois. Founded in 1995
Overview UnityPoint Clinic is actively recruiting for a PMHNP to join our virtual team. Choose a career that matters at UnityPoint Health. At UnityPoint Health, we believe that our patient-centered vision and physician-driven philosophy, along with our one team approach, ensures every patient knows just how much they matter to this world. Commitment to our team has earned us recognition as a Top 150 Places to Work in Healthcare by Becker’s Healthcare. Come be an essential part of our core purpose—to improve the health of the people and communities we serve. At UnityPoint Health, you matter. UnityPoint Clinic UnityPoint Clinic is a physician-led, nonprofit health care organization offering comprehensive services in primary care, walk-in care and specialty care. The clinical teams at the area’s clinics are improving outcomes, lowering the number of hospital readmissions and reducing avoidable costs associated with treating chronic conditions. The UnityPoint Clinic team is known for excellence and quality patient care putting patients at the center of their care to provide the best level of health and well-being. Responsibilities - PRN - Join a telehealth team providing Behavioral Health consults for Emergency Department patients at the following hospitals: Allen (Waterloo), Finley (Dubuque) and St. Luke’s North (Sioux City) - Fully remote shift-based role: 7 AM – 7 PM or 7 PM - 7 AM - No call - Ability to work as a team member to improve the health of the people and communities we serve - Patient-focused, friendly and willing to collaborate in a team environment - Excellent communication (written and verbal), analytical, and problem-solving skills Qualifications - PMHNP - Board certified - Prior psychiatry and/or remote work experience preferred - Strong internet connection - Ability to obtain and hold an unrestricted license to practice in the state of IA - Hold current and unrestricted state and federal authority to prescribe and administer medications as necessary or appropriate to the Advanced Practitioners field of practice - Eligible to work in the United States (H1-B cap exempt) We offer - Initial 2-year salary guarantee with ability to exceed on an innovative compensation program - Shift based compensation with performance incentive - Salary based position with performance incentive - Competitive compensation package - - Attractive incentive package - A competitive Total Rewards program offers benefits that align with your needs and priorities, no matter what stage of life you are in. - Generous time off and CME allowance, malpractice insurance, retirement contributions and more - Dedicated provider resources to positively impact providers work-life balance - Eligibility for Public Service Loan Forgiveness, including a free third-party service for loan restructuring and consolidation. - A commitment to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation. - Support and development opportunities that are a crucial part of delivering a remarkable employment experience. - A culture guided by uncompromising values and unwavering belief in doing what’s right for the people we serve.



