Sr. Manager, Reimbursement (Remote)

BioTissue; Miami (FL); Remote; USD 139,000 - 200,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

401(k) Retirement Savings Plan

Paid Time Off

Parental Leave

Tuition Reimbursement

Job summary

BioTissue is seeking a Sr. Manager, Reimbursement (Remote) to bridge payers, providers, and patients across BioTissue’s regenerative programs.

The role partners with physician practices to support patient access and reimbursement, covering coding, prior authorizations, and claims management. The ideal candidate will have 5+ years in market access or related fields, strong payer policy knowledge, and the flexibility to travel up to 60%.

Qualifications

• Bachelor’s degree in a related field; Master’s preferred.
• 5+ years of market access, specialty pharmaceuticals or surgical devices experience.
• 3+ years of direct experience in reimbursement, payer policy, or healthcare policy is preferred.
• Experience in eyecare or ophthalmology is advantageous.
• Expertise with physician-administered injectables and/or medical devices, including CPT/J-codes, buy‑and‑bill, and payer interactions.
• Experience navigating Medicare, Medicare Advantage, commercial, and Medicaid payers.
• Willingness to travel ~60% for territory coverage and trainings.

Responsibilities

• Partner with commercial and 3rd party teams to remove barriers to patient access.
• Educate Sales teams and providers on benefit verification, prior authorizations, and cost-sharing.
• Lead calls, webinars, and virtual office hours on payer policies and denial trends.
• Act as primary reimbursement resource for field reps to drive utilization and payer confidence.
• Collaborate with Market Access leadership to develop coding guides and payer updates.
• Guide coding, payer policies, claims approvals, and appeals for denials/underpayments.
• Monitor payer policy changes and escalate issues affecting patient access.
• Lead business and claims reviews with leadership.
• Maintain relationships with regional and national payer landscapes.

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Sr. Manager, Reimbursement (Remote)

Atlanta, GA, US

21 days ago Requisition ID: 1719

Salary Range: $139,356.00 To $200,000.00 Annually

About BioTissue & our Culture

At BioTissue, we transform the gift of life by sharing miracles. We are a diverse community, where talent and teamwork are core to who we are. Here, you are EMPOWERED to do the work you love, be yourself, and make an impact. Resilient and committed to our vision, we embrace challenges, celebrate courage, and take great pride in our work to create life-changing products. Purpose led us here. Passion and legacy keep us going.

Position Summary

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.

Essential Duties & 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.

Position Expertise/Qualifications

• 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 withMedicare, 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.

Total Rewards

At BioTissue, we believe our people are our greatest asset. We offer a comprehensive Total Rewards package designed to support employees' health, financial wellbeing, professional growth, and work‑life balance.

Our benefits may include:

• Medical, Dental, and Vision Insurance
• Health Savings Account (HSA) and Flexible Spending Accounts (FSA)
• 401(k) Retirement Savings Plan
• Company‑Paid Basic Life and AD&D Insurance
• Voluntary Life and AD&D Insurance
• Short‑Term and Long‑Term Disability Coverage
• Employee Assistance Program (EAP)
• Legal and Identity Protection Benefits
• Pet Insurance
• Paid Time Off and Company Holidays
• Paid Parental and Birthing Leave
• Family and Medical Leave (FMLA), where applicable
• Tuition Reimbursement and Professional Development Support
• Performance‑Based Incentive Opportunities
• Equity or Stock Programs, where applicable

Benefits eligibility and offerings may vary based on position, location, and employment status.

ADA Statement

BioTissue is committed to providing reasonable accommodations to qualified individuals with disabilities throughout the hiring process and employment lifecycle. If you require assistance or accommodation to participate in the application process or perform the essential functions of a position, please contact us to discuss your needs.

Qualified applicants with disabilities will be considered for employment and may be eligible to perform the essential functions of the position with or without reasonable accommodation.

Equal Employment Opportunity

BioTissue is committed to fostering a workplace where everyone feels valued, respected, and empowered to contribute. We welcome applicants from diverse backgrounds and experiences and are proud to be an Equal Opportunity Employer. Employment decisions are based on qualifications, merit, and business needs, without regard to any legally protected characteristic.