Field Reimbursement Manager

The Field Billing Manager will be the face of HeartFlow in supporting our customer’s administration and billing professionals to ensure they can successfully bill and collect reimbursement on FFRct claims. He/she will collaborate with HeartFlow’s Marketing team to create relevant educational material and educate and support our Sales team on coding and billing concerns, including attending sales calls at customer sites. He/she will work directly with the customer to ensure compliant coding of FFRct, educate them on components of the code and associated charges and payment, and provide support on prior authorization workflow and claims appeals.

This position will be a remote position with up to 50% travel throughout the US required. #LI-IB1 #LI-Remote

Job Responsibilities:

• Work with Marketing to create and disseminate educational materials around coding, billing, prior authorization and appeals.
• Support commercial team by addressing coding and billing concerns throughout the sales and implementation process.
• Conduct conference calls or travel onsite to customers to educate on appropriate use of Category III codes and billing scenarios.
• Work with revenue cycle management both at customer site and internally with HeartFlow Access Program.
• Read and interpret medical records to align with medical policy language to ensure accurate submission of claims. Partner with internal and external stakeholders to identify, anticipate and address patient and practice reimbursement issues
• Collaborate with Field Sales team to identify facilities and practices that need reimbursement education and support regarding HeartFlow products.
• Address questions associated with patient coverage, access, and reimbursement from accounts in collaboration and coordination with patient services as directed by policy and procedure.
• Conduct frequent claim reviews with practices to ensure appropriate reimbursement of HeartFlow products.
• Maintain a deep understanding of HeartFlow policies and requirements and perform the role in a compliant manner consistent with company guidance.
• Keep abreast of customer and market access industry trends.
• Provide coverage, coding, and reimbursement information to key staff members (i.e., practice administrators, reimbursement staff, and providers) in order to appropriately support patient access.
• Collaborate with field facing “One Team” to compliantly share insights into customer needs, potential barriers, and payer issues/opportunities for access at practices.

Skills Needed:

• Outstanding knowledge of coding and billing in US healthcare system, including Medicare and commercial payers.
• Proficient in the use of Excel, Word, and PowerPoint with advance spreadsheet development skills
• Excellent communication skills and customer support attitude.
• Strong understanding of hospital billing and coding infrastructure, including EMR, billing system, and personnel involved.
• Ability to interpret policies and medical necessity language to identify appropriate ICD-10 codes and medical records to submit claims.

Educational Requirements & Work Experience:

• Greater than 5 years of demonstrated work experience in coding and billing at a US hospital managing both governmental and commercial claims reimbursement processes.
• Demonstrated medical service coding and reimbursement experience.
• Associates Degree in related field of study required.
• CPC preferred, COC preferred, cardiology experience a plus.
• Bachelor’s degree preferred.

This position is remote, however, you must be located in one of the following states as listed or be able to relocate. Please note, at this time, we are not able to sponsor re-location.

A reasonable estimate of the base salary compensation range is $84,500 to $110,000 per year, cash bonus, and stock options.