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
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