Field Reimbursement Manager

🔥 32 minutes ago

⛰️ Colorado, Illinois, +1 more states – Remote

⛰️ Colorado – Remote 🌽 Illinois – Remote ❄️ Minnesota – Remote

💵 $165k - $185k / year

⏰ Full Time

🟠 Senior

🔴 Lead

👔 Manager

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Vericel® Corporation

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1989

🏥 Healthcare

🧬 Biotechnology

⚕️ Healthcare Insurance

💰 $74.8M Post-IPO Equity on 2018-06

Healthcare • Biotechnology • Healthcare Insurance

Vericel Corporation is a biotechnology company that manufactures and markets advanced cell therapy products aimed at the sports medicine and severe burn care markets in the United States. It offers unique treatments such as MACI for knee cartilage repair and Epicel for burn care, and holds exclusive rights to the biological product NexoBrid for eschar removal of severe thermal burns.

📋 Description

• Educate healthcare facilities on procurement, reimbursement, and billing options for Vericel products • Support new sites of care with initial ordering, onboarding, and reimbursement processes • Assist facilities in identifying appropriate coding, billing, and reimbursement pathways under the medical benefit • Follow up with sites throughout the reimbursement lifecycle to track claims submission, payment status, and resolution of reimbursement issues • Assist customers with appeals and reconciliation for under-reimbursement, including non-direct billing agreement contracts • Support customers in securing single case agreements for Epicel® and/or MACI® • Identify and address product procurement and reimbursement challenges to minimize treatment delays, cancellations, or reductions • Partner with Commercial, Market Access, Sales, and Operations teams to support customer needs and develop and execute access and reimbursement strategies • Collaborate with hub services, specialty pharmacy, and other contracted partners • Build and maintain relationships with billing departments, procurement teams, CFOs, and revenue cycle leaders • Participate in knowledge-sharing initiatives to improve market awareness of reimbursement dynamics and best practices • Analyze reimbursement and program data to identify trends, risks, and opportunities and communicate actionable insights to the Commercial organization • Serve as an internal and external subject matter expert on reimbursement policies, payer requirements, and access challenges

🎯 Requirements

• 7+ years of progressive experience in healthcare reimbursement, market access, or a related field • 3–5 years of experience as a Field Reimbursement Manager or in a similar field-based reimbursement role • Strong understanding of medical benefit reimbursement, CPT/HCPCS coding, and hospital billing processes • Experience working with hospital accounts and site-of-care stakeholders, including billing, revenue cycle, procurement, and administrative teams • Experience supporting reimbursement for complex biologics and surgical procedures • Strong understanding of payer and reimbursement policies and their impact on prescriber behavior, patient access, and sales force activity • Experience with appeals, reconciliation, under-reimbursement, and/or single case agreements • Experience supporting products used in hospital or surgical settings • Ability to work cross-functionally within a matrix organization and with external partners • Strong communication, relationship-building, analytical, and problem-solving skills • Self-directed and proactive, with ability to identify opportunities, solve problems, and operate effectively in an evolving environment • Data-driven mindset with experience translating insights into actionable strategies • Bachelor’s degree preferred

🏖️ Benefits

• Bonus, incentive pay, equity and benefits may be provided in addition to base compensation • Mission-driven work helping bring potentially life-enhancing cell therapies to patients • Career growth opportunities • Supportive, cross-functional collaborative culture

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