Reimbursement Analyst II | San Juan, Puerto Rico

Additional Location(s):  N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.       

We want you to bring your unique strengths to our team. We are committed to empowering women, supporting the LGBTQ+ community, and creating opportunities for individuals with disabilities. We believe that your diversity is our strength, and we are committed to fostering an environment where you can not only thrive but also bring your authentic self to work. As an equal opportunity employer, we wholeheartedly welcome applications from all qualified candidates, regardless of who you are or where you come from.

Purpose Statement:

Implements reimbursement strategies and programs to obtain coverage from pay or/ providers. Identifies managed healthcare opportunities and issues an implements programs to resolve/decrease barriers to entry for the company's product therapies. Complements and assists the sales force.  Conducts pay or/provider financial audits and presentations to hospitals.  Provides customers with information regarding reimbursement, and assists hospitals in adopting this new treatment. Addresses coverage issues with the government.

About the role:

• Patient case management role that includes health insurance provider’s billing
• Supporting Sales organization in 7 different therapeutic areas
• Hybrid environment (3 days at the office)
• Collaborative and professional growth environment

Your responsibilities will include:

• Timely patient cases management for implant procedure. Cases management cycle includes from pre-authorization requests to health insurance providers up to billing and reconciliation cycle.
• Interactions with clinical personnel from hospitals, physicians, health insurance providers and ambulatory surgical centers
• Direct communication with Boston Scientific field clinical representatives, sales representatives and divisional leaders.
• Interaction with Boston Scientific Puerto Rico case management and billing electronic platform.
• Proactive communication with related audience for patient access to therapy on a timely basis.
• Implements reimbursement strategies by evaluating the existing business environment and ensuring either internal or external resources are available to support these strategies.
• Evaluates incoming requests from the field and ensures each request is properly evaluated for feasibility, technical risk, cost and time constraints, compliance and other relevant considerations.
• Promotes reimbursement support and represents the company to external customers by writing, phoning, visiting, hosting and participating in events.
• Visits consultants to conduct studies of their operations, assess their efficiency and cost effectiveness, and evaluate their operations for potential business contract opportunities.
• Remains aware of changing reimbursement environment by interacting with field contacts, attending professional seminars/conferences and reading industry journals.
• Participates In external organizations, conferences and seminars to keep current with industry best practices in reimbursement.

Functional Knowledge

• Requires expanded conceptual and technical and/or functional knowledge in own job function
• Broadens capabilities in applying concepts in job function

Business Expertise

• Demonstrates working knowledge of business and industry practices and company processes to accomplish own work

Leadership

• No supervisory responsibility; accountable for own contributions and meeting objectives

Problem Solving

• Uses and exercises judgment to solve problems in straightforward situations and determine appropriate action/solutions.
• Works under general direction from more senior level roles/manager

Impact

• Impacts quality of own work and the work of others on the team; works within guidelines and policies
• Interactions (and Communications)
• Explains factual information of limited complexity to others in straightforward situations
• Organizes, presents and explains data/ information, primarily to internal audiences

Required qualifications:

• Education - associate or bachelor’s degree in business or science related field o minimum two (2) years’ experience with customer service (medical related field).
• Bilingual (Spanish & English) English as a second language.
• Proactive.
• Team Player, results oriented, “Can do attitude”
• Internal and external customer focus

Preferred qualifications:

• Higher education or courses in medical coding and billing
• Medical devices experience
• Soft skills: proven ability to work with people from different clinical environments

Requisition ID: 598394

Minimum Salary: $52300 

Maximum Salary: $99400 

The anticipated compensation listed above and the value of core and optional employee benefits offered by Boston Scientific (BSC) – see www.bscbenefitsconnect.com--will vary based on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be hired near the bottom or top of the anticipated salary range listed above.

Compensation for non-exempt (hourly), non-sales roles may also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).

Compensation for exempt, non-sales roles may also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements).

For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.

As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do – as a global business and as a global corporate citizen.

So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!

At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. 

Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identify, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status.  Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment.  Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements.   As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.