Job Description
Field Reimbursement Manager Remote (Preference for candidates based in Southeast, Northeast or Central U.S.) Company Summary: Enterra Medical, Inc is dedicated to helping more people with chronic gastroparesis live better lives through advancing technology, bolstering clinical science, and accelerating patient access to Enterra Therapy™. The FDA approved the Humanitarian Device Exemption for Enterra Therapy in 2000. Over 15,000 people have received Enterra Therapy to help resume everyday activities. In 2022, Enterra Medical assumed commercial responsibility of Enterra Therapy.
Position Summary: The Field Reimbursement Manager (FRM) will be responsible for supporting the company’s health economics, reimbursement, and market access strategy. This role will collaborate closely with the VP Health Economics along with Sales and Marketing team members to develop and deliver reimbursement support for clinicians and accounts providing Enterra Therapy. Other responsibilities may include leading direct payor advocacy strategies, evidence planning, and constructing health economic tools.
Duties and Responsibilities: - Be the subject matter expert on coding, coverage, and payment for Enterra Therapy with external and internal stakeholders.
- Develop and deliver reimbursement and health economic materials for value analysis committees, service line directors, purchasing / materials management staff, billing/coding staff, and other value purchasers.
- Cultivate relationships with key hospital and physician practice finance and billing teams.
- Address reimbursement issues and partner with accounts to support prior authorization or claim resolution.
- Serve as a strategic business partner with field sales leadership to develop and deliver value messaging.
- Provide in-service training to sales and customers to increase awareness and understanding of coding and billing for Enterra Therapy.
- Support policy advocacy efforts through physician partnership and trade organization work groups and meetings as needed.
- Build relationships in assigned markets with government, physician, hospital, and third-party payor decision makers.
- Provide reimbursement support to expand therapy access, including supporting the reimbursement hotline.
- Other duties as assigned.
Position Requirements: Education: - Bachelor’s degree in business, science or healthcare administration required.
Experience and Requirements: - Minimum of 5 years proven experience in medical device reimbursement and/or experience working with complex insurance payer claims, denials, and appeals (Medicare and commercial)
- Demonstrated knowledge in coding, coverage, and payment for implantable medical devices across the healthcare landscape including HCPs, ASCs, hospitals
- Knowledge of private payer, Medicare and Medicaid, and other insurance systems’ structures, policies & reimbursement processes
- High attention to detail and customer support
- Ability to analyze and interpret regulations and legislation on coding, coverage & reimbursement in the medical device industry
- Knowledge of reimbursement compliance requirements and a high level of personal integrity to promote a compliant reimbursement environment
- Proficient in Microsoft Office applications, including Word, PowerPoint and Excel
- Preferred experience with Gastroenterology procedures and products
- Preferred Coding certifications (CPC, COC)
- Excellent verbal and written communication skills
- Superior organizational skills and attention to detail
- Ability to travel up to 30%
Job Tags
Full time, Remote job,