Field Reimbursement Manager-New England

Role: Field Reimbursement Manager (FRM) supporting Harrow's buy-and-bill retinal and surgical portfolios in ME, NH, VT, and MA. Objectives: enhance patient access via reimbursement expertise and practice education. Responsibilities: serve as in-market contact for practice staff on payer coverage, coding, billing, prior authorization, and claims; conduct business reviews, analyze claims data, identify denial trends, and develop intervention strategies; build strong account relationships and coordinate with HUB and sales teams; provide insights on payer policies and escalate systemic issues. Requirements: 7+ years in healthcare reimbursement or related fields; minimum 2 years field reimbursement experience; buy-and-bill experience essential; proficiency in HCPCS, CPT, ICD-10, modifiers; knowledge of Medicare, Medicaid, commercial payer policies; experience with benefit verification, prior authorization, appeals, claims analysis. Preferred: eye care, private equity, HCPCS Level II, transitional pass-through reimbursement expertise, healthcare certification, and experience in engaging with Medicare Advantage and Medicaid plans. HighValue: focus on high-cost retina and surgical therapies, buy-and-bill model, extensive payer and claims analysis, territory with up to 80% travel, remote work setup.