Hybrid Field Reimbursement Manager

at Cleerly

• Job title: Field Reimbursement Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $127,000 - $164,000 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, United States

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