• Assist the Sales team by providing technical, clinical and educational/training support • Conduct patient/customer product demonstrations/training • Attend patient device implants and perform follow-ups to assure success • Provide external staff education on product related specifications • Support sales representatives by identifying clients' clinical needs • Ensure timely product follow-up and support to patients and staff • Manage administrative tasks including patient documentation in Salesforce • Collaborate and educate physicians and hospital personnel on SPR products

• Represents Medtronic during surgical procedures by ensuring access to all necessary equipment and products required for the case, device selection, programming, implantation and testing of all device systems • Provides clinical support in surgeries, troubleshooting and follow ups in hospitals and clinics • Responds promptly and appropriately to technical inquiries by customers, patients, and colleagues • Maintains a working knowledge of competitive products • Educates and trains physicians, hospital personnel and office staff on technical matters relating to our products and therapies • Assists Management and Sales Training department in education/training of new employees in the district • Complies with required event reporting and documentation utilizing Medtronic technology tools • Accountable to place an order with customer service for pending purchase orders and product replacement and is responsible for working with materials management to collect POs for cases covered within the territory/district • Responsible for managing inventory provided for case coverage • Contributes to the achievement of quarterly goals associated with specific initiatives at the district and/or national level • Partners with sales representatives to achieve business goals set forth within the territory/district and documents quarterly activities utilizing provided business tool(s) • Visits accounts to replenish literature and establishes /maintains relationships with office staff • Ability to effectively use a mobile phone, IPAD and PC • Ability to manage personal expenses and budget effectively • Ensures personal understanding of all quality policy/system items that are personally applicable • Follows all work/quality procedures to ensure quality system compliance and high-quality work

Role Description The Senior Denial Specialist is responsible for the timely and accurate resolution of denied claims in accordance with current contracts, federal regulations, and SHC policies. The Senior Denial Specialist serves as a subject matter expert and has extensive experience in denial resolution and recovery. Responsibilities may include high dollar and complex denial review and resolution, complex appeals, and serves as a mentor for new employees. The Senior Denial Specialist position is an expert-level position with a proven track record in hospital and physician denial resolution, and has an extensive knowledge of reimbursement requirements of all types of healthcare payers. A Senior Denial Specialist will act as a key resource for management in problem-solving difficult issues, analyzing complex accounts, and assisting with training needs. What you will do - Work a broad range of denied claims taking necessary actions to recover and resolve in accordance with contracts, federal regulations, and SHC policies. - Conduct root-cause analysis on denied claims to identify opportunities for mitigation and escalation. - Monitor high dollar and complex denial work queues, follow up on denied or underpaid appealed claims, and track appeal deadlines. - Collaborate with appropriate leadership and stakeholders to escalate trends and issues related to internal processes or external payer behavior. - Maintain accurate documentation in Epic and related systems; ensure compliance with privacy and regulatory requirements. - Support special projects related to high dollar or complex denials as assigned by management. - Provide cross-functional communication with Revenue Cycle teammates, payers, and patients as needed to resolve denial issues professionally. Qualifications - High School diploma or GED equivalent. - Five (5) years of progressively responsible and directly related work experience in healthcare revenue cycle, with a minimum of three (3) years of direct experience in denial management. Requirements - Working knowledge of government and non-government payer requirements, reimbursement rules, laws, and regulations that govern billing/collection activities. - Working knowledge of Epic Hospital and/or Professional Billing; proficiency in Epic reporting preferred. - Working knowledge of medical terminology, CPT-4, ICD-9/ICD-10, HCPCS, and modifiers, and how these items drive reimbursement. - Analytical and problem-solving skills, with good judgment, attention to detail, and thorough follow-through. - Excellent verbal and written communication skills; ability to present complex data clearly to stakeholders. Licenses and Certifications - CPC - Certified Professional Coder required Upon Hire or - CRCR - Certified Revenue Cycle Representative required Upon Hire. Company Description Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery. - Know Me: Anticipate my needs and status to deliver effective care. - Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health. - Coordinate for Me: Own the complexity of my care through coordination.

Role Description The Senior Clinical Denials Appeal Specialist serves as a clinical subject matter expert focused on resolving and appealing clinically related, documentation-related, and clinical operations-related denials. This role performs detailed account and medical record reviews to assess and determine appropriate resolution activity, takes necessary actions to resolve clinical denials, and prepares compliant, evidence-based appeal submissions when needed. The Senior Clinical Denials Appeal Specialist operates under established guidelines and supervision, ensuring accurate, timely, and consistent appeal decisions aligned with clinical criteria, regulatory requirements, and organizational standards. - Evaluates clinically related denials and takes necessary actions to resolve, including preparing and submitting clinical appeal arguments and appeals to government, commercial, and managed care payers in accordance with federal, state, and local regulatory requirements. - Conducts thorough analyses of assigned denials, evaluating the clinical validity of diagnoses, appropriateness of medical services and procedures. - Ensures all appeal submissions are accurate, compliant, and submitted within required timelines. - Identifies missing or insufficient documentation and collaborates with internal departments to obtain needed information. - Maintains detailed and accurate documentation of appeal activity in designated systems. - Meets productivity, quality, and turnaround time expectations. - Follows standardized workflows, templates, and escalation protocols. - Operates within established guidelines with supervisory support as needed. Qualifications - Bachelor’s Degree (BSN) is highly preferred. Diploma or Associate’s Degree in Nursing accepted when accompanied by strong demonstrated competencies and significant experience. - Minimum of five (5) years in nursing with a minimum of two (2) years’ experience as Utilization Management Nurse in an acute care setting required. UM or CM leadership experience preferred. - Experience and working knowledge of 2 Midnight, Milliman, and InterQual Guidelines required. - Minimum of two (2) years of experience in denial prevention, denial recovery, clinical appeals, or related denial-management responsibilities within a healthcare setting. - Experience with Epic HB and PB highly desirable. Requirements - Strong understanding of ICD-10-CM/PCS, CPT/HCPCS coding, and medical necessity guidelines. - Strong understanding of clinical operations within a hospital or ambulatory care setting. - Strong understanding of 2 Midnight, Milliman, and InterQual Guidelines. - Familiarity with payer policies, reimbursement methodologies, and CMS guidelines (including Medicare/Medicaid rules) and common commercial payer practices. - Knowledge of CDI concepts, documentation standards, and revenue cycle processes. - Ability to establish and maintain effective working relationships. - Working knowledge of hospital and physician revenue cycle systems, including Epic. Licenses and Certifications - CA Registered Nurse - Valid license as a Registered Nurse issued by the California Board of Registered Nursing (BRN). - CCRC - Cert Clin Resch Coord preferred. Benefits - SHC Commitment to Providing an Exceptional Patient & Family Experience. - Equal Opportunity Employer - Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. - Base Pay Scale: Generally starting at $66.52 - $88.14 per hour.