Field Reimbursement Manager-West
RemoteWest, Texas, United States
Job Summary
Serve as the primary field point of contact for practice administrators, billing/coding staff, and clinical staff on reimbursement matters related to Harrow buy-and-bill brands. Provide non-promotional education on payer coverage policy, medical benefit billing/coding, prior authorization requirements, and claims submission best practices. Support practices through the prior authorization and appeals process by educating staff on payer-specific requirements and documentation needs. Build and maintain trusted relationships with key accounts within the CA, OR, WA, and ID territory to conduct regular business reviews and identify denial trends. Proactively identify at-risk accounts and develop targeted intervention plans while partnering with Sales to ensure a coordinated, compliant approach. Conduct account-level claims analysis to identify denial patterns and translate findings into actionable guidance for the practice. Escalate systemic or complex payer issues to National leadership with supporting data and recommendations. Partner closely with the HUB and Patient Services team to ensure seamless coordination on benefit verification and patient assistance. Provide regular field intelligence and account-level insights to leadership to inform national strategy and payer engagement. Maintain accurate, timely documentation of account activity, business reviews, and issue resolution in CRM/reporting systems. Represent Harrow professionally and compliantly at all times, strictly adhering to all applicable laws, regulations, and company policies.
Required Qualifications
- 7+ years of proven success in the healthcare-related field, reimbursement, brand management, and/or sales experience
- Buy-and-bill experience
- Minimum 2 years of Field Reimbursement experience
- Up to 80% travel
Desired Qualifications
- Bachelor's degree preferred, or equivalent work experience
- Healthcare credentialing and/or certification preferred
- Eye care experience preferred
- Private equity experience preferred
- HCPCS Level II (J-code) and Transitional Pass-Through reimbursement experience preferred
- Experience with benefit verifications, prior authorizations, claim assistance, and appeals
- Payer coverage experience with Medicare (MACs), Medicare Advantage, Commercial, and Medicaid plans
- Experience in conducting claims analysis and conducting regular QBRs with accounts
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