Harrowhealth

Field Reimbursement Manager-Mid-Atlantic

Mid-Atlantic . Posted 3 months ago

The role

The Field Reimbursement Manager serves as an in-market expert for physician practices using Harrow's buy-and-bill drug portfolio. This role 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, 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 (Nasdaq: HROW) 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.

Field Reimbursement Manager-Mid-Atlantic at Harrowhealth | JobZoey