Field Reimbursement Manager - Mid-Atlantic

Greater than 5 years of demonstrated work experience in coding and billing at a US hospital managing both governmental and commercial claims reimbursement processes. Demonstrated medical service coding and reimbursement experience. Associates Degree in related field of study required. Outstanding knowledge of coding and billing in US healthcare system, including Medicare and commercial payers. Proficient in the use of Excel, Word, and PowerPoint with advance spreadsheet development skills. Excellent communication skills and customer support attitude. Strong understanding of hospital billing and coding infrastructure, including EMR, billing system, and personnel involved. Ability to interpret policies and medical necessity language to identify appropriate ICD-10 codes and medical records to submit claims. CPC preferred, COC preferred, cardiology experience a plus. Bachelor’s degree preferred.

Create and disseminate educational materials around coding, billing, prior authorization and appeals. Support commercial team by addressing coding and billing concerns. Educate customers on appropriate use of Category III codes and billing scenarios. Work with revenue cycle management both at customer site and internally. Read and interpret medical records to align with medical policy language for claim submission. Partner with internal and external stakeholders to address patient and practice reimbursement issues. Collaborate with Field Sales team to identify facilities and practices needing reimbursement education. Address questions associated with patient coverage, access, and reimbursement from accounts. Conduct frequent claim reviews with practices to ensure appropriate reimbursement. Maintain a deep understanding of Heartflow policies and requirements. Keep abreast of customer and market access industry trends. Provide coverage, coding, and reimbursement information to key staff members. Collaborate with field facing “One Team” to share insights into customer needs and payer issues.