Field Reimbursement Manager-New England

The role

The Field Reimbursement Manager serves as an in-market expert for physician practices using buy-and-bill drug portfolios. This person provides non-promotional education on coverage, coding, billing, and claims processes to expand patient access to therapies.

What you will do

• Serve as the primary field point of contact for practice administrators, billing/coding staff, and clinical staff on reimbursement matters
• Provide non-promotional education on payer coverage policy, medical benefit billing/coding, prior authorization requirements, and claims submission
• Support practices through the prior authorization and appeals process
• Educate practices on available support programs and coordinate handoffs to the HUB
• Build and maintain trusted relationships with key accounts within an assigned territory
• Conduct regular business reviews with accounts to assess reimbursement performance and identify denial trends
• Identify at-risk accounts and develop targeted intervention plans
• Partner with Sales to align on account priorities
• Conduct account-level claims analysis to identify denial patterns or coding errors
• Maintain knowledge of payer policies including commercial, Medicare, Medicare Advantage, and Medicaid

Required qualifications

• 7+ years of proven success in the healthcare-related field, reimbursement, brand management, and/or sales experience
• Buy-and-bill experience required
• Minimum 2 years of Field Reimbursement experience required
• 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

Nice to have

• Bachelor’s degree
• Healthcare credentialing and/or certification
• Eye care experience
• Private equity experience
• HCPCS Level II (J-code) and Transitional Pass-Through reimbursement experience

About the company

Harrow is a leading provider of ophthalmic disease management solutions in North America. It is an entrepreneurial company focused on innovation and patient access to affordable medicines.