DME Sales - Workers’ Compensation at Altivera Medical

Job Details

This role focuses on strengthening provider engagement, education, and long-term partnership by helping customers successfully navigate Workers’ Compensation requirements, reimbursement considerations, documentation expectations, authorization processes, and appropriate utilization of NexWave. The Specialist develops trusted relationships with providers and their teams, identifies barriers to successful patient access and treatment, and coordinates with internal partners to help resolve issues and improve the overall provider experience.

Critical Competencies

• Workers’ Compensation Expertise – Demonstrates a strong understanding of Workers’ Compensation processes, payer and TPA dynamics, utilization review, authorization requirements, reimbursement considerations, documentation expectations, and provider workflows.
• Provider Education & Support – Translates complex Workers’ Compensation requirements into practical guidance for providers and clinic teams, helping them understand appropriate utilization, documentation, ordering, and approval processes.
• Relationship Management – Builds trusted, long-term relationships with providers, clinic leadership, case managers, TPAs, adjusters, and other Workers’ Compensation stakeholders through responsiveness, credibility, and consistent follow-through.
• Consultative Problem Solving – Identifies barriers affecting provider experience, patient access, approvals, or utilization and works cross-functionally to develop practical solutions.
• Stakeholder Communication & Influence – Effectively communicates clinical, operational, and reimbursement-related information to a variety of clinical and non-clinical audiences.
• Independent Ownership – Manages assigned relationships and priorities with a high degree of accountability while maintaining strong coordination with internal Sales, Intake, Billing, and Operations partners.

Core Responsibilities

Serve as a Workers’ Compensation Resource

• Develop and maintain a strong working knowledge of Workers’ Compensation processes, reimbursement structures, utilization review requirements, and applicable treatment guidelines.
• Educate providers and clinic teams on Workers’ Compensation considerations that may impact ordering, documentation, authorization, and utilization of NexWave.
• Help providers understand documentation expectations and other requirements that support efficient review and approval.
• Provide ongoing guidance as Workers’ Compensation requirements, payer expectations, and internal processes evolve.
• Serve as a knowledgeable point of contact for provider questions related to the Workers’ Compensation patient journey.

Educate and Support Providers

• Conduct provider education, in-services, onboarding, and ongoing account support.
• Educate clinical and administrative teams on appropriate patient identification, ordering processes, documentation requirements, and NexWave utilization.
• Reinforce NexWave’s role within appropriate treatment pathways, including early intervention when clinically appropriate.
• Tailor education and support based on provider type, workflow, patient population, and Workers’ Compensation experience.
• Identify knowledge gaps or process challenges and provide targeted education to improve provider confidence and experience.

Build and Maintain Strong Relationships

• Develop trusted relationships with occupational medicine clinics, urgent care centers, physical therapy and musculoskeletal providers, case managers, TPAs, adjusters, and other Workers’ Compensation stakeholders.
• Maintain regular communication with assigned accounts to understand needs, challenges, and opportunities for additional support.
• Serve as a responsive partner for providers navigating Workers’ Compensation questions or operational challenges.
• Strengthen relationships across provider organizations by engaging clinical, administrative, and operational decision-makers.
• Support long-term account retention and engagement through consistent service, education, and follow-through.

Improve Provider and Patient Access

• Identify barriers affecting ordering, authorization, documentation, fulfillment, or ongoing utilization.
• Partner with Intake, Billing, Operations, and other internal teams to resolve account-specific issues and improve the provider experience.
• Help establish efficient, repeatable workflows that make it easier for providers to support appropriate Workers’ Compensation patients.
• Identify recurring issues or trends and communicate insights internally to support broader process improvements.
• Follow through on provider concerns and ensure appropriate internal resources are engaged through resolution.

Partner Across the Workers’ Compensation Ecosystem

• Develop productive relationships with TPAs, case managers, adjusters, managed care organizations, and other stakeholders influencing Workers’ Compensation treatment and access.
• Communicate the clinical and operational value of NexWave within Workers’ Compensation treatment pathways.
• Support stakeholder understanding of appropriate utilization, documentation, cost considerations, recovery, and return-to-work objectives.
• Help identify opportunities to improve alignment between provider workflows, payer requirements, and internal processes.

Support Sustainable Account Growth

• Identify opportunities to expand appropriate NexWave utilization within existing provider relationships.
• Support engagement with new providers and Workers’ Compensation partners where education and relationship development can create long-term value.
• Use account activity, referral trends, provider feedback, and utilization patterns to identify opportunities for additional education or support.
• Focus on developing sustainable provider relationships and repeatable workflows rather than transactional referral generation.
• Maintain visibility into account engagement, opportunities, barriers, and follow-up activities.

Qualifications

• 2+ years of healthcare, Workers’ Compensation, provider relations, account management, sales, or related experience; Workers’ Compensation experience strongly preferred
• Experience working with occupational medicine, physical therapy, musculoskeletal care, Workers’ Compensation, or related healthcare environments preferred
• Working knowledge of Workers’ Compensation reimbursement, authorization, utilization review, documentation, or claims processes
• Demonstrated ability to develop and maintain strong relationships with healthcare providers and other clinical or operational stakeholders
• Strong presentation, education, communication, and relationship-management skills
• Ability to explain complex reimbursement or operational concepts clearly to clinical and non-clinical audiences
• Strong problem-solving skills with the ability to coordinate across multiple internal teams
• Ability to work independently, manage multiple relationships and priorities, and maintain consistent follow-through
• Valid driver’s license and ability to travel as needed to support assigned accounts and provider relationships