Field Reimbursement Manager - Northeast

Organogenesis Inc.; United States; Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player in regenerative medicine is seeking a Field Reimbursement Manager to facilitate patient access to innovative wound care solutions. In this dynamic role, you will leverage your expertise in coding, coverage, and payment to educate healthcare providers and optimize reimbursement processes. The ideal candidate will possess strong analytical and communication skills, with a commitment to building relationships and driving results. This remote position offers the opportunity to work closely with cross-functional teams and make a meaningful impact in the healthcare landscape, empowering healing for patients in need.

Benefits

401k with employer match

Comprehensive Medical, Dental and Vision coverage

Flexible Spending Account

Company paid insurances

Paid maternity and parental leave

Adoption benefits

Education Assistance Policy

Wellness Program

Employee Assistance Program

Generous paid time off

Qualifications

• 2+ years of experience in medical billing/coding or healthcare insurance.
• Strong analytical and problem-solving skills required.

Responsibilities

• Educate HCPs on coding, coverage, and payment for patient access.
• Analyze reimbursement issues and coordinate with internal teams.
• Act as mentor for Benefit Verification/Benefit Assurance teams.

Skills

Analytical Skills

Problem Solving

Communication Skills

Leadership Skills

Relationship Building

Education

BS/BA degree

Tools

MS Office

Job description

We are a leading regenerative medicine company in the advanced and acute wound care space and are always looking for exceptional talent. Join a company where you will have an opportunity to grow professionally and personally and give strength to others by Empowering Healing. Our advanced wound care products are specially developed for the successful treatment of chronic and acute wounds. Our comprehensive portfolio of skin substitutes and other regenerative medicine products empower our patients with life-changing solutions. Our strength is giving others strength.

Learn more about Careers at Organogenesis

What you will achieve:

Organogenesis is seeking an experienced and dynamic individual for a Field Reimbursement Manager (FRM). This position will operate as the subject-matter expert on coding, coverage, and payment issues related to the Organogenesis portfolio of products. Field Reimbursement Manager has a comprehensive understanding of all aspects of reimbursement models (coding, coverage, and payment), including complete understanding of Medicare A, B, C and D benefit designs, Medi-gap, physician fee schedule and ability to locate applicable coverage policies. Demonstrated advanced level billing competencies including CPT, ICD-10, HCPCS coding and EOB interpretation. Ability to negotiate and execute sophisticated/C-suite level site of care discussions related to various health care topics, product access and reimbursement. The position reports to the Field Reimbursement Director and is a remote position. The ideal candidate needs to live near a major airport and be located in the Northeast region of the United States.

How you will achieve it:

• Educate HCPs and their staff on matters related to coding, coverage, and payment to facilitate appropriate patient access to ORGO products.
• Analyze reimbursement issues and act as the reimbursement resource for other field sales force personnel and region management.
• Coordinate with all internal teams concerning individual patient cases and overall coordination with provider and local sales team.
• Collaborate cross functionally with Field Sales, Marketing, Payer/Policy, Senior Leadership, Sales Training, and Medical Affairs while abiding by all corporate and industry policy guidelines and procedures.
• Analyze provider claim forms for errors and recommend corrective measures for claim submissions.
• Analyze remittance for denied claims; Guide providers through the appeal process.
• Act as mentor and escalation point for Benefit Verification/Benefit Assurance teams.
• Perform Business Reviews/Claims Analysis for providers.
• Work with C-Suite personnel to educate on the benefits in the utilization of ORGO products to treat chronic and surgical wounds.
• Reimbursement subject matter expert for assigned area.
• Onboarding new customers.

Requirements

What you will need to achieve it:

• Requires BS/BA degree.
• 2+ years of medical billing/coding, medical/pharmaceuticals sales, hospital revenue cycle, or healthcare insurance/payer experience.
• Demonstrate analytical, problem solving, critical thinking, and relationship-building skills.
• Excellent communication, organizational and leadership skills.
• Ability to travel up to 60% of the time. Face-to-Face interaction with customers preferred.
• AAPC billing/coding certification preferred.
• Must demonstrate a commitment to building strong relationships with customers.
• Collaborates to build strategic vision and skills across the organization.
• Possesses strong consultative skills.
• Ability to manage multiple projects simultaneously.
• Proven problem-solving skills.
• Committed to working as a teammate.
• Proficient in MS Office.
• Exceptional written and verbal communication skills.
• Principled, honest, creative, enthusiastic, independent, curious, coachable, solution-minded.

What can we offer you?

• 401k -- generous employer match with immediate vesting and financial planning resources.
• Comprehensive Medical, Dental and Vision coverage options effective on day one of employment.
• Flexible Spending Account (medical expenses or dependent care expenses) or Health Savings Account.
• Company paid insurances including Short Term, Long Term and Life insurances as well as voluntary options.
• Paid maternity leave and parental leave for all new parents.
• Adoption benefits.
• Education Assistance Policy - $5,000 per year for all employees.
• Wellness Program including free trainings on mental health, mindfulness, stress reduction, on-site flu shots and more.
• Employee Assistance Program.
• Generous paid time off including vacation, floating holidays, sick days, and company holidays.
• Free parking including an electric charging station (Canton and La Jolla).
• Discounts at BJs Wholesale, Dell, Sullivan Tire, and Sprint.

Physical Demands

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 pounds at times.
• Must be able to travel 70% of the time to work with customers and the field.

Environmental Conditions

• Sometimes in clinical or hospital settings.

We are an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, genetic information or any other characteristic protected by law.