Senior Nurse Appeals Analyst

Senior Nurse Appeals Analyst

JOB SUMMARY:

The Senior Nurse Appeals Analyst is responsible for managing and analyzing all medical content and supporting the Reimbursement team with appeals to minimize the financial burden for patients. Additional responsibilities include, preparing for and representing Novocure in all teleconference hearings, ensuring that timeliness guidelines are met, and appeals are handled in compliance with regulatory requirements of CMS and other agencies. The Senior Nurse Appeals Analyst will be responsible for training and development of new and tenured team members. This position will build and manage relationships with internal and external partners, including collaboration with and supporting other Revenue Operations functional teams.

This is a full-time, exempt position reporting to Director, Payer Contracting and Relationship Management based in Portsmouth, NH.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Analyze medical records to provide accurate information according to policies and procedures
• Enhance appeal methodologies through data analysis, aiming to overturn denials effectively.
• Provide accurate and thorough testimony for teleconference hearings, including ALJ and State Fair Hearings
• Utilize problem solving and creative thinking in order to prepare clinical summaries and appeal letters, with the ability to review and edit templates as needed
• Conduct intricate data analysis to offer valuable insights for informed business decisions
• Manage and maintain confidential information, ensuring it is handled securely and in compliance with the Novocure's policies and procedures
• Efficiently manage multiple tasks and deadlines, ensuring that all assignments are completed accurately and in a timely manner
• Support the training and development of both new and experienced team members
• Establish and maintain positive working relationships with internal and external partners
• Support internal and external audits as needed
• Lead and support team projects as assigned
• Fulfill any additional duties or directives provided by management

QUALIFICATIONS/KNOWLEDGE:

• 4-6 years in a medical device or DME company and/or neuro oncology background, preferred
• Active RN license required; Bachelor's or Master's degree preferred
• Exceptional proficiency in written and verbal communication
• Thorough understanding of government and commercial appeals process
• Comprehensive knowledge of medical and oncology regulatory environments
• Proficiency in oncology-specific terminology
• Ability to adhere to company policies and procedures and follow directions
• Proficiency in analytical thinking, problem-solving and prioritization
• Excellent communication and presentation skills
• Ability to analyze data and report out
• Proficient in coordinating meetings and delivering presentations
• Effectiveness in de-escalating and resolving complex situations required
• Ability to solve problems and set priorities required
• Experience in project management and leading teams.
• Familiarity with Microsoft Office and SAP preferred
• Ability to work both independently and collaboratively in a team environment required

• Ability to work cooperatively in a fast-paced office setting required

OTHER:

• Ability to lift up to 20 pounds

ABOUT NOVOCURE:

Our vision

Patient-forward: aspiring to make a difference in cancer.

Our patient-forward mission

Together with our patients, we strive to extend survival in some of the most aggressive forms of cancer by developing and commercializing our innovative therapy.

Our patient-forward values

- innovation

- focus

- drive

- courage

- trust

- empathy