Field Reimbursement Manager

Magnus Medical•Washington, DC

3d•$120,000 - $140,000•Remote

About The Position

The Field Reimbursement Manager is Magnus Medical’s primary field-based expert in billing and reimbursement, supporting healthcare providers, administrators, and billing professionals in successfully navigating coverage and payment for our breakthrough neuromodulation technology. This role plays a critical part in ensuring accurate, compliant coding and billing practices while promoting a clear understanding of payer requirements and workflows. In addition to delivering hands-on customer education, the Field Reimbursement Manager provides support across the entire reimbursement lifecycle including prior authorization, claims submission, appeals, and denial management. They work closely with internal and external teams to align strategies, tools, and messaging to support provider success. This includes sharing real-time field insights and working together to proactively address payer-specific challenges, streamline authorization workflows, troubleshoot claim denials, and optimize appeal strategies.

Requirements

Deep knowledge of coding and billing practices within the U.S. healthcare system, including Medicare, Medicaid, and commercial payers
Experience guiding providers in adding new therapies or technologies into the hospital/professional charge master, ensuring correct revenue code and HCPCS mapping.
Revenue Code Knowledge: Strong understanding of revenue codes and their appropriate alignment to procedures and devices.
Strong understanding of behavioral health and neurology coding, particularly for outpatient hospital settings and novel technology adoption
Familiarity with Category III CPT codes (T-codes), including their temporary status, implications for coverage decisions, and documentation requirements
Experience supporting appeals and prior authorization workflows involving T-codes, and understanding of CMS review timelines and payer adoption cycles for emerging technologies
Proficiency in Microsoft Excel, Word, and PowerPoint, with the ability to develop and analyze tracking tools (e.g., claims monitoring spreadsheets, reimbursement dashboards)
Excellent communication and interpersonal skills, with a strong customer support mindset and ability to work cross-functionally across clinical, administrative, and commercial teams
Familiarity with hospital and outpatient billing infrastructure, including electronic medical record (EMR) systems, billing platforms, and provider workflows
Ability to interpret payer policies and medical necessity requirements to assess claim readiness and ensure complete, accurate documentation
Comfortable presenting to both small and large groups (virtually or in person) and tailoring education to a range of provider audiences
Ability to think independently, analyze complex coverage issues, and provide strategic recommendations to support provider access and ensure patients receive appropriate coverage.
Strong understanding of the healthcare regulatory and enforcement environment, with a demonstrated commitment to integrity in navigating payer policies, benefit verification, and patient access pathways.
Proficient in navigating EMR/EHR systems and other provider-facing platforms; able to understand internal provider workflows and documentation processes to support access and reimbursement efforts effectively.
Associate’s degree in healthcare administration, health information technology, or a related discipline required
At least 5+ years of relevant experience in medical billing and coding, with a strong understanding of reimbursement workflows for both public (e.g., Medicare, Medicaid) and private/commercial payers
Direct experience navigating the reimbursement landscape for innovative healthcare services or medical technologies, including claims follow-up, denials, and appeals
Certification as a Certified Professional Coder is required; additional credentials such as Certified Outpatient Coder are a plus

Nice To Haves

Bachelor’s degree is preferred and may substitute for equivalent field experience in some cases.
Familiarity with neuromodulation, behavioral health, psychiatry, or TMS (transcranial magnetic stimulation) preferred

Responsibilities

Support the commercial team by addressing coding, billing, and reimbursement concerns throughout the sales, onboarding, and implementation process.
Conduct virtual and onsite meetings with customers to educate on appropriate use of procedure codes, documentation requirements, and billing best practices for SAINT.
Collaborate with revenue cycle teams and relevant stakeholders to ensure clean claims submission and timely reimbursement.
Review and interpret medical records to assess alignment with payer medical policies and documentation standards.
Partner with internal and external stakeholders to identify, anticipate, and resolve reimbursement-related challenges that impact patient access and provider adoption.
Work closely with external teams to align on payer strategy, track field-level trends, and jointly address prior authorization, claims, denials, and appeals support needs for the provider sites.
Work closely with the field sales team to identify provider sites that may benefit from reimbursement education, claims support, or workflow optimization.
Address coverage, access, and reimbursement questions from provider accounts in collaboration with external teams, consistent with policy and compliance requirements.
Perform periodic claims reviews with practices to help ensure proper reimbursement and proactively identify any underpayments or denials.
Maintain a strong understanding of Magnus policies, payer requirements, and the evolving reimbursement landscape to perform all duties in a compliant and informed manner.
Stay current on market access and payer trends impacting behavioral health and neuromodulation technologies.
Provide relevant reimbursement and access insights to key stakeholders, including practice administrators, billing staff, and providers, to support efficient patient access to SAINT.