Medical Records and Authorization Specialist

This is where your work makes a difference.

At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond.

Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results.

Here, you will find more than just a job—you will find purpose and pride. 

Perform Medical Records and Authorization Specialist duties including documentation collection and review, prior authorization and reauthorization submissions, The Medical Records and Authorization Specialist communicates directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies as well as collaborating cross-functionally with other Cardiology Health teams to coordinate in our mission of Saving and Sustaining Lives.

What You'll Do:

• Ensure coverage and payer requirements.

• Gather clinical documentation to support medical necessity for Cardiology devices.

• Process paper and electronic correspondence, including logging and distribution of payer and patient inquiries.

• Establish and maintain positive partnerships with sales team and healthcare teams.

• Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met.

• Prepare and submit prior authorization initial and renewal requests to all insurance companies including.

• Process authorization decisions from payers timely to streamline and drive revenue.

• Identify payer trends and establish payer-specific strategies to overcome reimbursement challenges.

• Provide superior customer experience by leveraging the ability to discuss payer policies, coverage criteria, or any pertinent product information with patients and healthcare teams.

• Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance.

• Consistently contribute to team goals and understand how they support greater organizational goals.

• Actively seek additional experience and knowledge across all functional areas to gain expertise.

• Provide workload coverage as needed.

• Perform other duties and projects as assigned.

What You'll Bring:

• High school diploma or equivalent required, Associates degree or higher preferred

• 3+ years of industry experience in health insurance

• Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations

• Third party payer experience strongly preferred.

• Experience in reviewing medical records and obtaining third-party payer reimbursement.

• Exceptional written, verbal, and interpersonal communications

• Strong critical thinking and problem-solving skills

• Detail orientated and ability to multi-task

• Ability to work independently as well as in a team environment

• Possess the ability to manage time and prioritize critical priorities

• Proficiency in Microsoft Office Software

Baxter is committed to supporting the needs for flexibility in the workplace. We do so through our flexible workplace policy which includes a minimum of 3 days a week onsite. This policy provides the benefits of connecting and collaborating in-person in support of our Mission.

We understand compensation is an important factor as you consider the next step in your career. At Baxter, we are committed to equitable pay for all employees, and we strive to be more transparent with our pay practices. The estimated base salary for this position is $49,600 - $53,000 annually. The estimated range is meant to reflect an anticipated salary range for the position. We may pay more or less than of the anticipated range based upon market data and other factors, all of which are subject to change. Individual pay is based on upon location, skills and expertise, experience, and other relevant factors. This position may also be eligible for discretionary bonuses. For questions about this, our pay philosophy, and available benefits, please speak to the recruiter if you decide to apply and are