Field Reimbursement Manager-Mid-Atlantic

Responsibilities:
- Serve as primary field reimbursement contact for physician practices using Harrow buy-and-bill brands.
- Provide non-promotional, compliant education on payer coverage, medical benefit billing/coding (HCPCS/CPT/J-codes, ICD-10, modifiers), prior authorization, and claims submission.
- Support prior authorization and appeals with payer-specific requirements and documentation guidance.
- Educate on support programs (patient assistance, product replacement, sample programs) and coordinate HUB handoffs.
- Build relationships with key accounts and conduct regular QBRs to review reimbursement performance, denial trends, and action plans.
- Identify at-risk accounts (e.g., high denial rates/low utilization) and develop targeted interventions; partner with Sales for coordinated support.
- Perform account-level claims and payer analysis; translate findings into actionable guidance.
- Maintain current payer-policy knowledge (commercial, Medicare, Medicare Advantage, Medicaid); escalate complex issues with supporting data to leadership.
- Coordinate with HUB/Patient Services for benefit verification, PA/appeals, and patient assistance; provide field intelligence; document activities in CRM/reporting systems.

Qualifications/Requirements:
- 7+ years healthcare reimbursement/brand management/sales experience.
- Bachelor’s preferred (or equivalent).
- Buy-and-bill experience required.
- Minimum 2 years Field Reimbursement experience required.

Preferred Skills/Experience:
- Healthcare credentialing/certification; eye care; private equity.
- HCPCS Level II (J-code) and Transitional Pass-Through reimbursement.
- Experience with benefit verification, prior auth, claim assistance, and appeals.
- Payer coverage experience: Medicare (MACs), Medicare Advantage, Commercial, Medicaid.
- Claims analysis experience and conducting regular QBRs.

Work Setup:
- Remote; travel up to 80%.