Sr. Manager, Field Reimbursement

BioTissue Holdings Inc•Miami, FL

27d

About The Position

The Field Reimbursement team, part of the BioTissue Market Access organization, serves as a bridge between payers, providers, and patients to ensure timely and equitable access to BioTissue’s regenerative technologies. The team functions as subject matter experts in payer policy, patient access, and provider support, helping to eliminate reimbursement barriers and optimize the treatment journey. The Sr. Field Reimbursement Manager partners with physician practices, including both private clinics and hospital-based institutions, to support appropriate patient access and reimbursement processes. This role engages directly with physicians, administrators, office staff and internally to deliver education and hands-on support in areas such as clinical documentation, prior authorizations, claims submission and reconciliation, patient tracking, inventory management, and copay assistance In addition, the Sr. Field Reimbursement Manager provides guidance on accurate coding and billing practices for BioTissue products in alignment with payer policies and compliance standards. The position also assists healthcare providers in identifying and addressing barriers that could delay or limit patient access to therapy or impact clinical outcomes. The ideal candidate is organized, detail-oriented, and excels at collaboration. Strong communication skills, emotional intelligence, and the ability to manage multiple cross-functional priorities are essential for success in this role.

Requirements

Bachelor’s degree in a related field. Master’s preferred
Minimum of 5 years of experience in market access, specialty pharmaceuticals or surgical devices in a professional capacity.
At least 3 years of direct experience in reimbursement, payer policy, or healthcare policy is preferred.
Experience in eyecare or ophthalmology is advantageous.
Demonstrated expertise in physician-administered injectables and/or medical devices, including working with Category III CPT codes, miscellaneous J-codes, specialty pharmacy, buy-and-bill processes, benefit verification, prior authorizations, claims management, and appeals.
Experience navigating coverage and reimbursement with Medicare, Medicare Advantage, commercial, and Medicaid plans.
Strong understanding of healthcare provider reimbursement challenges and practice economics.
Willingness and ability to travel as needed to support territory coverage, including overnight travel (~60%), and participation in required trainings and meetings.
Demonstrated leadership and project management skills.
Experience educating Healthcare Professionals on the availability of patient support programs such as Co-Pay Assistance and Patient Assistance Programs.

Nice To Haves

Master’s preferred
At least 3 years of direct experience in reimbursement, payer policy, or healthcare policy is preferred.
Experience in eyecare or ophthalmology is advantageous.

Responsibilities

Partner with the commercial team and 3rd party support teams to remove barriers to patient access.
Educate the Sales team and healthcare providers and office staff on benefit verification, prior authorizations, patient cost-share, and drug acquisition options.
Lead scheduled calls, webinars, and virtual office hours on payer policies, common denial trends, and reimbursement best practices.
Act as the primary reimbursement resource for field reps, supporting them with proactive strategies to drive utilization and payer confidence.
Collaborate with Market Access leadership to develop standardized tools (coding guides, payer updates, talking points).
Guide coding, payer policies, claim approvals, and appeals for denied or underpaid claims.
Monitor reimbursement trends and payer policy changes, escalating issues that may affect patient access.
Lead business and claims reviews in collaboration with leadership.
Maintain knowledge of and build relationships with regional and national payer landscapes, utilization management, and prior authorization processes.
Communicate policy updates clearly to customers and internal stakeholders.
Uphold compliance with regulatory and ethical standards related to patient assistance programs.