Reimbursement Specialist l

About The Role

We are seeking a Reimbursement Specialist I to support core reimbursement activities that help confirm medical necessity, secure accurate payment, and reduce the financial impact on patients. In this role, you will conduct benefit investigations, submit and follow up on authorization and referral requests, address claim and authorization denials, support single case agreements, and partner with teams across Revenue Operations to help achieve departmental goals.

This is a full-time, non-exempt position based in our Portsmouth, NH office and reports to the Supervisor or Manager of Reimbursement. The ideal candidate brings foundational knowledge of reimbursement workflows and is able to complete assigned work accurately and on time with limited supervision.

Responsibilities

• Conduct timely insurance benefit verifications to determine patient eligibility and cost-share responsibilities for new and existing patients
• Accurately identify the appropriate bill-to insurance party
• Submit prior authorization requests to insurance carriers and follow up by phone or through insurance portals with minimal supervision
• Interpret authorization denials and draft appeals, when necessary, with limited supervision
• Research and interpret commercial payer medical policies and coverage guidelines
• Verify the presence and accuracy of authorizations and pricing agreements for insured patients
• Differentiate between contract and non-contract carriers and identify contacts for potential letter of agreement (LOA) negotiations
• Escalate contracting implementation challenges and identify opportunities for process improvement
• Collaborate cross-functionally to support timely and accurate reimbursement from insurance providers
• Follow up promptly on outstanding insurance balances by phone and through insurance websites
• Investigate and resolve incorrect payments and escalate identified trends
• Submit and track claim appeals related to payment disputes
• Identify when a claims project may be needed
• Communicate with key personnel at managed care organizations, including nurse case managers, to help streamline reimbursement processing for patients
• Perform additional duties and respond to shifting priorities as assigned by management

Requirements

You are detail-oriented, persistent, and comfortable working through reimbursement issues that require accuracy, follow-through, and clear communication. You can navigate conversations with insurance companies and internal partners, de-escalate challenging situations, and stay organized in a fast-paced office environment. You work well independently with limited supervision while collaborating effectively across teams. You bring a working knowledge of medical and insurance terminology and are motivated by the opportunity to help reduce barriers for patients.

Qualifications

• Bachelor’s degree or equivalent experience preferred
• 0–2 years of experience in a reimbursement-related function; DME-specific experience preferred
• Demonstrated knowledge of medical and insurance terminology
• Demonstrated effectiveness communicating with insurance companies regarding medical policies and contracts
• Proven written and verbal communication skills with internal and external customers
• Ability to effectively de-escalate and resolve difficult situations
• Ability to work independently with limited supervision
• Ability to work efficiently and cooperatively in a fast-paced office setting
• Integrity and tenacity when working accounts

Preferred Qualifications

• DME-specific reimbursement experience
• In-depth knowledge of Microsoft Office and SAP

Schedule

Based in our Portsmouth, NH office

Full-time, non-exempt position reporting to the Supervisor or Manager of Reimbursement

Collaborate closely with Revenue Operations and other internal teams to support reimbursement goals and patient needs

Manage multiple priorities with accuracy, timeliness, and limited supervision

Ability to lift up to 20 pounds

Pay

The pay range which Novocure expects to pay for this role at the time of this posting is $43,000 - $58,000/yr. This position may also be eligible for an annual bonus and restricted stock unit grant in addition to a full range of benefits. Individual compensation within this range depends on a variety of factors, including, but not limited to, prior education and experience, job-related knowledge and skills demonstrated.

Benefits

This position is eligible for a full range of benefits.