Market Access Specialist I

Status: Full Time, Exempt

Reports To: VP, Payor Relations & Market Development

A. Purpose and Scope of Position

This position is responsible for brand reimbursement and patient access strategies, achieving and maintaining positive payer coverage policies for Coflex products, coding and payment policies affecting the Coflex portfolio. This role will consult with surgeons, distributors, and patients, analyze commercial payer policy, recommend and draft patient access and reimbursement strategies, and work cross-functional and across payer types to facilities appropriate market access for the Coflex products.

B. Organizational Relationship

This position reports to the VP, Payor Relations & Market Development, and coordinates with various departments to advise on Xtant Patient Access Program and reimbursement pathway for the Coflex product lines.

C. Duties and Responsibilities

1. Specific Job Duties/Responsibilities
   • Build relationships and act as a partner to Field Sales and Distributor teams in regards to insurance, reimbursement, and the Xtant Patient Access Program
   • Prepare, consult, analyze, and participate in the launch and daily management of the Xtant Reimbursement strategy and pathway for the Coflex product line.
   • Prepare, analyze, track and contribute to the Xtant Patient Access Program in partnership with PRIA Healthcare.
   • Identify, develop, and executive opportunities by focusing on appropriate positioning and messaging of Coflex products within targeted payer and customer segments
   • Establish and maintain strong relationships with PRIA, reimbursement consultants, key commercial and government payer organizations, and distributor partners.
   • Collaborate and coordinate across functions (Sales, Marketing, Research) to achieve Coflex goals
   • Continuous development and updating for constant improvement of all content submitted to payers in support of patients and physicians seeking Coflex.
   • Support the internal commercial team, as well as patients, physicians, and office staff in the education of coflex, authorization process, appeals process, XPAP, and general reimbursement.
   • Partner with development and sales to support XPAP program awareness, efficiency, and progress.
   • Conduct market analysis and assessments when necessary to identify reimbursement trends, challenges, and opportunities.
   • Contribute to the development of Coflex evidence generation and market access strategies.
2. Financial Responsibilities
   • Submit timely expense reports and abide by the Expense Reimbursement Policy
3. Training
   • Participate in training plans and programs and complete in a timely manner within set deadlines
   • Complete required training prior to attempting to perform a task
   • Maintain required training documentation
4. Management
   • This position does not supervise others
5. Document Control and Record Control
   • Assist in the completion and retention of documentation pertaining to all SOPs as required
   • Legibly and accurately complete all documentation associated with assigned duties in accordance with GDP and review the written documentation of others as required
   • Maintain information in physical and electronic files as required
   • Train on and demonstrate proficiency in Xtant Medical’s document control system
6. Other duties as assigned
7. Performance of Duties
   • Complete required training, including initial orientation and environmental health and safety training, prior to performing tasks. Keep training up to date
   • Perform all duties according to established procedures and follow appropriate safety precautions and measures
   • Conduct himself/herself in a professional and courteous manner in all aspects of interaction with fellow employees, surgeons, staff, and end users
   • Maintain a clean and safe working environment at all times
   • Must maintain confidentiality of donor and recipient information according to HIPAA

D. Job Requirements

1. Education/Credentials Experience & Training

• Bachelors degree (health economics, life science, nursing, or public health) preferred.
• One (1) or more years’ relevant work experience
• Candidates with significant experience in a medical office or hospital setting managing teams for coding and prior authorization will also be considered.
• In-depth knowledge and experience of healthcare reimbursement systems, policies, and procedures.
• Ability to work cross functionally to provide input on programmatic and operational improvements

2. Knowledge, Skills & Abilities

• Strong ability to communicate both orally and in written format
• Ability to effectively communicate accounting and financial concepts to non-financial management
• Demonstrated ability to perform analysis, use discretion and make sound decisions
• Experience with NetSuite and CRM a plus
• Demonstrated ability to resolve problems and issues
• Ability to take initiative, action-oriented and able to motivate others in positive ways
• Requires highly analytical nature and ability to manipulate data using tools such as Microsoft Excel
• Demonstrated ability to work independently and maintain a schedule for completion of tasks
• Must be results-oriented, with the ability to multi-task and a readiness to adapt to changing departmental needs, products, and fees

3. Managerial Experience

• N/A

4. Working Conditions

• Standard office hours are Monday – Friday; 8:00 am – 5:00 pm.
• Work will require occasional weekend/evening work and travel
• Work may require long periods of sitting, standing, and working at a computer

5. Health and Safety

• Must adhere to all health and safety requirements specified when entering laboratory and device manufacturing areas and in the handling of company products
• This position may require the use of personal protective equipment during various tasks/activities including but not limited to, gloves, masks, and safety glasses
• Ability to lift to 10 lbs.

Note: This Job Description is not designed to include a detailed listing of the activities, duties or responsibilities that may be required of the employee. This job description does not constitute an employment contract, implied or otherwise, and is subject to change by the employer as the needs of the employer and requirements of the job change.

** This position does not offer current or future H-1B Visa Sponsorship **

Xtant Medical provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.