Field Reimbursement Manager

Description

The Field Reimbursement Manager (FRM) will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting the Kerecis products. 

FRMs have a comprehensive understanding of all aspects of reimbursement models (coding, coverage, and payment), including complete understanding of Medicare A, B, C and D benefit designs, Medi-gap, physician fee schedule and ability to locate applicable coverage policies Demonstrated advanced level billing competencies including CPT, ICD-10, HCPCS coding and EOB interpretation. Ability to negotiate and execute sophisticated/C-suite level site of care discussions related to various health care topics access and reimbursement and able to set and pull through account level access strategies.

- Educate HCPs and their staff on matters related to reimbursement, access and coverage to facilitate appropriate patient access. 

- Analyze reimbursement and access issues and act as the local access and reimbursement resource for other field sales force personnel and region management. 

- Coordinate with the BI/Reimbursement Team concerning individual patient cases and overall coordination with provider and local sales team. 

- Collaborate cross functionally with Field Sales, Marketing, Payer/Policy, Senior Leadership, Sales Training, and Medical Affairs while abiding by all corporate and industry policy and procedures.

- Analyze provider claim forms for errors and recommend corrective measures for claim submissions.

- Analyze remittance advices for denied claims; Guide providers through the appeal process.

- Act as mentor and escalation point for Benefit Investigation team.

Requirements

Competencies

- Bachelors Degree

- 2+ years of medical billing/coding, medical/pharmaceuticals sales, hospital revenue cycle, or healthcare insurance/payer experience

- Demonstrate analytical, problem solving, and relationship-building skills.

- Excellent communication, organizational and leadership skills

- Ability to travel up to 50% of the time. Face-to-Face interaction with customers preferred.

- AAPC billing/coding certification preferred.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time. Kerecis LLC is an equal opportunity employer.