Hybrid Field Reimbursement Manager

Posted 2 months ago

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About the role

  • Field Reimbursement Manager representing Cleerly in healthcare reimbursement matters. Collaborating with sales and clients to enhance understanding of billing and reimbursement processes.

Responsibilities

  • Direct customer engagement through in-person or online meetings.
  • Maintain a detailed understanding of all market access and reimbursement related information related to all Cleerly products and related services in all settings of care.
  • Maintain a detailed knowledge of and ability to utilize all Cleerly resources and tools for customer assistance.
  • Educate internal stakeholders, such as sales, marketing, etc., on nuances to coding, coverage, and reimbursement and how to communicate to customers in accordance with compliance standards.
  • Cross functional collaboration with Sales, Marketing, and Client Success teams to meet customer reimbursement needs across all phases of the sales process.
  • Cross functional collaboration with Sales and Implementation Teams to educate new and potential customers on patient access, reimbursement, and coding Cleerly products.
  • Regularly assess payor coverage policies for changes and communicate to internal and external stakeholders.
  • Identify, cultivate and maintain client relationships leading to KOL development for payor engagement.
  • Collaborate with Market Access Directors to engage KOLs for payor coverage engagement.
  • Assist Directors of Market Access with maintaining payor policy data.
  • Educate clients (including third party billers) on payor coverage topics, patient selection criteria, billing, coding, and reimbursement.
  • Work directly with new customer billing and coding teams to educate on prior authorizations, coding, coverage criteria, and other reimbursement related topics.
  • Initiate regular, scheduled communications with customers and billing staff to assess any issues and educate accordingly.
  • Assist customers with utilization of Cleerly tools and resources for prior authorizations and appeals.
  • Assess customer payor mix and perform claim reviews to ensure proper billing and coding.
  • Develop and share best practices with internal team regarding billing, coding and reimbursement processes.
  • Provide feedback to internal stakeholders regarding real-world access barriers and market dynamics.

Requirements

  • Associates degree in a medical or science related field, Bachelor’s degree preferred
  • Billing and coding expertise in radiology or cardiology
  • Certified Professional Coder (or similar) certification preferred
  • Minimum of 5 years of billing and coding experience in either office, hospital outpatient, or IDTF
  • Experience interpreting medical coverage policies to understand and communicate clinical criteria as well as billing and coding requirements
  • Outstanding knowledge of US billing and coding system for both commercial and government payors
  • Excellent written and interpersonal communication skills
  • Comprehensive understanding of billing and coding workflow in all sites of care including knowledge of EMR billing software, etc.
  • Must live near a major airport in the Western half of the United States
  • Must be able to travel up to 75% of the time.

Benefits

  • Health insurance
  • Paid time off
  • Professional development opportunities
  • Remote work options
  • Flexible working hours

Job title

Field Reimbursement Manager

Job type

Experience level

Mid levelSenior

Salary

$127,000 - $164,000 per year

Degree requirement

Associate's Degree

Location requirements

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