Director Reimbursement

Gateway Recruiting; United States; Hybrid; USD 150,000 - 200,000; Full time

Job summary

Gateway Recruiting seeks a Director, Field Reimbursement to lead a growing reimbursement commercial support team and to drive patient access across care settings. The role requires expertise with Category III CPT codes, ICD-10-CM/PCS, and hospital/physician payer contracting, including chargemaster and revenue cycle processes.

The candidate will mentor staff, set priorities, and collaborate with cross-functional partners to meet business objectives while presenting health economics topics to

Qualifications

• Bachelor’s degree required; master’s degree preferred.
• 5+ years of field reimbursement management experience.
• Strong leadership and cross-functional collaboration skills.
• Experience with hospital billing, coding, and payer contracting is a plus.

Responsibilities

• Provide leadership and day-to-day direction to the reimbursement field team.
• Coordinate workloads and ensure timely follow-through on deliverables.
• Build reimbursement capabilities with internal and cross-functional partners.
• Develop internal reporting tracking account and claim activity.
• Deliver on-site and virtual reimbursement training programs.

Skills

Leadership

Strategic thinking

Communication

Presentation skills

Education

Bachelor’s degree in related field

Master’s degree preferred

Job description

Position Summary

To support the company’s expanding commercialization the Reimbursement and Health Economics team is adding a Director, Field Reimbursement. This field-based role will build and lead the reimbursement commercial support team, develop tools and processes that improve patient access, address reimbursement barriers to support appropriate product utilization across care settings. The role includes being a subject matter expert with new and emerging technologies/procedures with both Category III & I CPT codes, ICD-10-CM/ICD-10-PCS codes, and various payment mechanisms for both hospitals (outpatient, ASC, and inpatient) and physicians. In addition, this position requires knowledge of payer coverage and hospital and physician contracts with payers.

Key Responsibilities

• Provide leadership and day-to-day direction and mentoring to the reimbursement field team, ensuring the team provide accurate and compliant information on billing, coding, and payment.
• The Manager must prioritize activities, coordinate workloads, and ensure timely follow-through on key deliverables.
• Engage internal team members and cross-functional partners to build reimbursement capabilities, strengthen collaboration, and support achievement of business objectives.
• Develop internal reporting mechanisms tracking account and claim activity.
• Ensure Reimbursement Managers develop and deliver on-site and virtual reimbursement training materials and programs.
• Identify account reimbursement barriers and develop solution-oriented team tools and deliverables.
• Troubleshoot, and assess hospital and physician Histotripsy coverage and payment issues and develop and implement plans to correct issues.
• Ensure Reimbursement Managers can present health economics and reimbursement topics to diverse audiences, including C-suite executives, physicians, and service line administrators, with a solutions-oriented focus.
• Engage key decision-makers within hospital administration, including chargemaster, finance, compliance, and provider contracting stakeholders, for reimbursement presentations that support adoption.
• Ensure all interactions adhere to corporate policies, compliance regulations, and industry guidelines.
• Travel as needed to support reimbursement execution, including site visits to physician practices or hospital administration, sales meetings, product training classes, and trade shows.
• Perform other duties as assigned.

Qualifications And Skills

• Bachelor’s degree in a related field; master’s degree preferred.
• 5+ years of field reimbursement management experience, including experience with hospital medical device capital equipment, Category III CPT codes, revenue cycle management, physician payment, Medicare and private payer payment models, hospital billing, and coding systems (including chargemaster, payer contracting, and revenue cycle management). Oncology experience is a plus.
• 3+ years of demonstrated team leadership experience with the ability to manage priorities and drive accountability across cross-functional initiatives.
• Strategic thinking skills and adaptability in a fast-paced startup environment.
• Thorough understanding of clinical and economic data, coding, coverage, and payment issues, including considerations unique to the reimbursement and market adoption of new technologies.
• High level of interpersonal skill in resolving conflict effectively.
• Excellent written, verbal, and presentation skills, with the ability to communicate persuasively with physicians, hospital administrators, and key opinion leaders.