| || The Novartis Group of Companies are Equal Opportunity Employers and take pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion or any other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, marital or veteran status, disability, or any other legally protected status. |
| || Education:
• A Bachelor’s degree required, ideally in business, marketing or relevant sciences related area
• A minimum of 5+ years of pharmaceutical/biotech/device industry experience, including minimum of 3+ year’s healthcare coverage, coding and/or reimbursement experience is required
• Previous experience working with billing and medical claims personnel in various health care settings, including, but not limited to a physician office, hospital, HOPD or ASC.
• Experience with implementing and executing Medicare, Medicaid, and Managed Care Payer initiatives.
• Proven expertise in supporting healthcare provider offices with coding, billing and submissions in range of payer environments.
• Familiarity with processes of CPT, HCPCS, ICD-9, revenue codes and DRG, coverage and reimbursement.
• Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur.
• Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies.
• Knowledge of government, state and commercial insurance systems, methodology, and reimbursement policies and processes.
• Ability to accommodate 50-70% travel.
• Candidate must reside within assigned territory- ideal location would be Illinois (Chicago surrounding area) or Minnesota (Minneapolis surrounding area)
• Territory and States covered include the following: J5 (Iowa, Kansas, Missouri & Nebraska) - J6 (Illinois, Minnesota & Wisconsin) and J8 (Michigan, Indiana, Ohio & Kentucky)- ideal candidate should live within 1 hour of a major airport