Field Reimbursement Manager - Northeast Area (NY, RI, CT, MA, VT, NH, ME)

Considering remote candidates in the following locations:  NY, RI, CT, MA, VT, NH, ME

ESSENTIAL JOB FUNCTIONS 

We are recruiting a Field Reimbursement Manager to join our team. In this provider/customer facing role, you will be instrumental in providing support to optimize Inspire access and minimize reimbursement barriers for patients and providers. You will be building relationships with providers, providers’ offices, Ambulatory Surgery Centers, hospital outpatient facilities, as well as other cross functional internal and external stakeholders. You will be working independently in a fast paced, highly visible environment as well as collaboratively with the internal program prior authorization support services and field sales to ensure all customer needs are met supporting patient therapy access and communicating coverage challenges across specific payer channels with guidance on how to navigate and minimize those potential hurdles. You will also actively engage with new accounts for billing and coding training, audit education, and program review support.

OPPORTUNITIES YOU WILL HAVE IN THIS ROLE 

• Be the subject matter expert on coding, coverage, and payment for Medicare and commercial payers and impact patient access through complex problem solving
• Effectively communicate and explain Inspire reimbursement education, support, and resources to customers in multiple sites of service including administrators
• Both proactively and reactively navigate and address individual account and patient access issues that occur by partnering with external and internal stakeholders including internal reimbursement team and field sales colleagues
• Respond to client and internal partner requests for customer site visits, Inspire program business reviews, and reimbursement needs/support
• Establish and maintain customer relationships through reimbursement related engagement and cross-functional partnerships including Sales, Marketing, Medical Education, and Legal and Compliance, etc.
• Execute on access and reimbursement strategic priorities, working with business partners to identify and prioritize key accounts for alignment of reimbursement support to achieve goals
• Collaborate in the development of reimbursement presentations for site visits, trainings, client presentations and other meetings as appropriate
• Keep abreast of ever-changing market dynamics and industry trends Inspire related impacts regarding to CMS and commercial payers
• Work in a fast-paced environment and manage additional related responsibilities based on organizational needs
• Build a culture of compliance that ensures that all activities are fully aligned with company quality system procedures/policies, applicable laws, regulations, and industries standards

WHAT YOU CAN BRING TO OUR GREAT TEAM

Required:

• Bachelor’s degree in business, science or healthcare administration required
• 7+ years of experience in reimbursement/market access and/or Successful experience working with complex insurance payer claims, denials, and appeals (Medicare and commercial)
• Demonstrated knowledge in coding, coverage, and payment for implantable medical devices across the healthcare landscape including HCPs, ASCs, hospitals
• Experience engaging directly with HCPs in multiple sites of service and in group educational settings
• Excellent communication and in person and virtual presentation skills to interface with customers, cross-functional partners, and internal reimbursement and prior authorization partners
• Independent and team-oriented problem solving and diligent self-motivated follow up
• Direct experience collaborating with multiple internal and external stakeholders and managing project
• Ability to travel regularly and up to 25%

Preferred:

• Implantable medical device experience
• Experience with Neurology products
• Coding certification (CPC, COC)

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