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Field Reimbursement Manager
HeartFlow, Inc. Operate as the embedded reimbursement expert within the commercial field team .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical coding, reimbursement processes, and payer policies, with a strong ability to educate and support commercial teams in optimizing billing strategies. Proven track record in managing complex reimbursement scenarios and navigating the healthcare landscape effectively.
Highest-signal resume keywords
Medical Coding Expertise (CPT, ICD-10-CM/PCS)Reimbursement Process OptimizationPayer Policy InterpretationClaims Appeals ManagementCustomer-Facing Education
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding and Billing ExperiencePrior Authorization WorkflowsClaims AdjudicationChargemaster Setup OptimizationClaim Review and Resolution
Soft Skills
Outstanding CommunicationAnalytical Problem SolvingCollaboration with Sales Teams
Tools & Technologies
Microsoft Office SuiteAdvanced Excel Skills
Certifications & Qualifications
CPC CertificationCOC CertificationCCS CertificationRHIA CertificationCHBME Certification
Industry Keywords
Healthcare ReimbursementCMS Coverage DeterminationsCommercial Payer PoliciesSouthwest Payer LandscapeMedical Device Reimbursement
About the role
Key responsibilities & impact- Operate as the embedded reimbursement expert within the commercial field team
- Attend strategic customer calls to address complex coding, billing, and access concerns
- Partner with the Field Sales Team to identify facilities needing reimbursement support and develop strategies
- Educate the commercial team on coding updates, billing trends, and payer developments
- Provide reimbursement support for providers and hospital billing and administrative leadership
- Conduct onsite visits and remote consultations on billing scenarios, documentation requirements, and payment components
- Support customers across the full reimbursement cycle, from pre-service authorization through post-service claims and appeals
- Optimize prior authorization workflows and claims appeals processes
- Review and optimize chargemaster setup for accurate charge capture and reimbursement
- Conduct claim reviews, identify patterns, and recommend resolutions
- Resolve patient coverage, access, and reimbursement questions with internal stakeholders
- Identify gaps in educational resources and communicate needs internally
- Monitor and communicate payer policy changes, CMS coverage determinations, and market access trends
- Surface systemic reimbursement opportunities and barriers to inform organizational strategy
- Maintain fluency in payer medical policies, prior authorization trends, and claims adjudication patterns across the Southwest
Requirements
What you’ll need- 5+ years of coding and billing experience managing both governmental and commercial claims, with demonstrated customer-facing or education/training responsibilities
- Demonstrated experience in medical service coding and reimbursement, including direct support of large health system or hospital billing optimization
- Proven experience operating alongside or embedded within a commercial sales organization
- Must reside in TX, CO, AZ, NM, WY, or UT
- Expert knowledge of medical coding (CPT, ICD-10-CM/PCS), payer policies, prior authorization workflows, and claims appeals processes across governmental and commercial payers
- Proven ability to interpret CMS Local and National Coverage Determinations and commercial payer medical policies
- Ability to monitor, synthesize, and act on payer policy changes, coverage trends, and access barriers
- Outstanding ability to translate complex reimbursement concepts into clear, actionable guidance
- Proficient in Microsoft Office Suite with advanced Excel skills
- Unwavering commitment to ethical business practices and compliance
- Bachelor's degree in a related field preferred; equivalent combination of education and experience will be considered
- CPC, COC, or CCS certification preferred
- RHIA or CHBME certification preferred
- Prior medical device, diagnostics, or specialty pharma field reimbursement experience preferred
- Familiarity with CMS NCD/LCD processes and commercial payer medical policy interpretation preferred
- Experience with cardiac or advanced imaging reimbursement and radiology benefit manager prior authorization preferred
- Working knowledge of the Southwest payer landscape preferred
Benefits
Comp & perks- Bonus
- Remote, field-based work
- Approximately 30% travel within the territory