Jolie Gischer

About Jolie Gischer

A researcher, navigator and engineer at heart, Jolie holds MA (2005) and BA (2003) degrees in Experimental Psychology with an emphasis in Behavioral Neuroscience from the University of MO-St. Louis.Highly driven and able to empathize with device leadership teams and their customers alike, Jolie has held director-level roles creating operational systems for device manufacturers and managed high-performing provider and patient hotline support teams responsible for verifying coverage and reversing medically necessary insurance denials. She has achieved career success through lobbying favorable policy legislation and product coverage policies among government and commercial health plans and eliminated product reimbursement obstacles for healthcare providers. Prior to entering the Medical Device space in 2008, Jolie managed medical billing and collections (A/R) for internal medicine, pediatric physicians, and air ambulance providers (since Specialties: Market Access, Reimbursement, Medical Devices, Diagnostics, Physician and Patient Advocate, CMS Regulations, Insurance Billing, Insurance Collections, CPT, HCPCS, ICD, Medical Accounts Receivable (A/R), Reimbursement Operations, Medical Policy, Reimbursement Hotline, Medical Claims, Evidence-Based Medical Appeals, Database Creation, Data Management

Experience

1. Founder & Principal, Reimbursement & Market Access Consultant

   Reimbursement Navigators

   Nov 2011 — Present · San Diego County, CA, US

   Market Access Consulting Offering Reimbursement Solutions for Manufacturers of Medical Devices & Diagnostics since 2011. LANDSCAPE ANALYSESUnderstand the reimbursement sandbox as it relates to existing, new-to-market, or pipeline products or technologies. Engage early in product development to identify internal and external strengths, weaknesses, opportunities & threats which can have long-lasting impacts on commercialization.MEDICAL POLICY AND FEE SCHEDULE TRACKINGIncrease market access opportunities by identifying Medicare and Commercial health plan medical policy coverage and/or outpatient fee schedule payment (i.e, PFS, ASP, HOPD, ASC, CLFS, DME) for your company’s products.CREATE TOOLS & RESOURCES FOR SALES ENABLEMENT AND REIMBURSEMENT SUPPORTSet clear reimbursement expectations for reps & customers alike; improve use and customer account receivables (A/R) through education, provider denial assistance, evidence-based appeal templates, national or territory-specific rate sheets and reimbursement manuals.TARGET & OBTAIN OR EXPAND PRODUCT COVERAGEImprove product sales and marketing opportunities by reducing market objections due to reimbursement or coverage. Plan payer strategies to gain positive government and commercial insurance coverage for technologies typically deemed “experimental, investigational, or unproven.\"SPECIAL PROJECTSExplore one-off projects to identify and solve coding, coverage, payment, modifier, claim billing and collection barriers. Examples may include, but are not limited to: Coding Applications, Draft Medical Policies or LCDs, Comment Periods for Proposed or Final CMS Rules; researching industry trends in legislation and regulation; evaluating and optimizing reimbursement hotline operations including systems, processes, and improvements.

Education

• San Diego State University

  Professional Certificate, Grant Writing

  2014 — 2014

• San Diego State University

  Professional Certificate, Meeting and Event Planning

  2015 — 2016

• San Diego College of Continuing Education

  Professional Certificate, Entrepreneurial and Small Business Operations

  2016 — 2017

• University of Missouri-Saint Louis

  MA, Experimental Psychology, Behavioral Neuroscience

  2003 — 2005

• University of Missouri-Saint Louis

  BA, Psychology

  2000 — 2003

Skills

• Virtual Teams
• Insurance Claims
• Cardiology
• Billing
• Hospitals
• Training
• Microsoft Office
• Medical Billing
• Payment
• Medicaid
• Entrepreneurship
• Accounts Receivable
• Outlook
• Reimbursement Operations
• Coverage
• Internal Medicine
• Medical Policy
• Documentation
• Appeals
• Medical Devices
• Medical Coding
• Medicare
• Cpt
• Medical Diagnostics
• Health Insurance
• Evidence-Based Appeals
• Reimbursement Hotline
• Software Documentation
• Microsoft Excel
• Powerpoint
• Database Design
• Insurance Billing
• Excel
• Problem Solving
• Insurance
• Mergers
• Policy
• Auditing
• Diagnostics
• Reimbursement