Field Reimbursement Manager-Northeast

Harrow, Inc.

80d

About The Position

Reporting to the Director- Provider and Patient Support, the Sr. Field Reimbursement Manager (Sr. FRM) will work with healthcare provider accounts and facilities to support access for Harrow’s ocular buy-and-bill products at both Ambulatory Surgery Centers (ASCs) and Retina/Ophthalmology physician practices. The Sr. FRM does this by providing product-specific provider reimbursement education and support as it relates to coverage, coding, and payment. The Sr. FRM will also work on patient level reimbursement issues, when authorized by providers/HCPs.

Requirements

• 8+ years of combined proven success in a healthcare-related field reimbursement, brand management and/or sales experience.
• Bachelor's degree.
• Buy-and-Bill experience required.
• Minimum 4+ years Field Reimbursement experience required.
• Healthcare credentialing and/or certification preferred.
• Minimum 6+ years Retina/Eye care experience preferred.
• Private Equity and/or Strategic account experience preferred.
• HCPCS Level II (J-code) and Transitional Pass-Through reimbursement preferred.
• Experience with benefit verifications, prior authorizations, claim assistance, and appeals required.
• Payer coverage experience with Medicare (MACs), Medicare Advantage, Commercial, and Medicaid plans required.

Nice To Haves

• Healthcare credentialing and/or certification.
• Private Equity and/or Strategic account experience.
• HCPCS Level II (J-code) and Transitional Pass-Through reimbursement.

Responsibilities

• Responsible for managing an assigned geography and providing product reimbursement assistance and approved support tools and resources to healthcare providers in physician practices and facilities.
• Provide in-person and/or virtual support to educate and train provider accounts and facilities on coverage, coding, and reimbursement of Harrow’s buy-and-bill-products, as well as Harrow Cares Patient Support Services HUB.
• Assists healthcare providers and staff in working through reimbursement barriers and understanding the payer landscape.
• Working knowledge of buy-and-bill and medical benefit reimbursement, as well as a clear understanding of Medicare, Medicare Advantage, Commercial, and Medicaid insurance plans and benefit design and coverage policies.
• Works effectively and cross-functionally with multiple key stakeholders (sales, marketing, managed markets, compliance, legal, and regulatory) in a matrixed environment to achieve business objectives and key performance indicators (KPIs).
• Subject matter expert on reimbursement processes (i.e., benefit verification, prior authorization, claim assistance, and appeals) and knowledgeable of current Retina/Ophthalmology/Ocular market dynamics.
• Builds and maintains strong relationships with HCP office, physicians, C-Suite leadership, practice administrators, and integral operational staff.
• Conducts all work activities in compliance with all internal requirements and meets all applicable business, compliance, legal, and regulatory requirements.

What This Job Offers

• Education Level: Bachelor's degree