Remote Coding Manager Jobs in Arizona (NOW HIRING)

Description
Job Title
Manager, Market Access & Reimbursement
Department
Billing and Reimbursement
Reports To
Chief Commercialization Officer
Location
On-Site - Mesa AZ or Remote
FLSA Classification
Exempt
Salary Range
116,200 - 170,000
Company Summary
BioLab Holdings is a biotechnology company committed to raising the standard of caring by developing, manufacturing, and commercializing breakthrough products with patient care in mind. At the heart of our work is a mission to optimize the standard of wound care through innovations grounded in science, compassion, and collaboration. We support healthcare distributors, providers, and patients worldwide who share our same initiatives to deliver clinical performance and real-world impact.
Position Summary
The Manager, Market Access & Reimbursement is responsible for leading day-to-day reimbursement operations and supporting market access activities across BioLab's product portfolio. This role partners with Commercial, Medical Affairs, Marketing, Compliance, Finance, and other internal stakeholders to help execute initiatives related to coverage, coding, pricing support, reimbursement readiness, and payer issue resolution.
This position provides leadership for reimbursement operations and the in-house Insurance Verification team, while contributing subject matter expertise in reimbursement, coding, billing, and payer policy interpretation. The role is expected to identify issues, recommend solutions, and escalate broader strategic or enterprise-level decisions to senior leadership as appropriate.
Essential Functions
Market Access & Reimbursement Support
• Support execution of market access and reimbursement plans across BioLab products.
• Partner with cross-functional teams to support reimbursement readiness, product access, provider adoption, and compliant billing practices.
• Identify reimbursement barriers, payer trends, and access risks, and recommend solutions to leadership.
• Assist in developing tools, training, and internal guidance to support field and customer reimbursement needs.
Payer Engagement & Policy Monitoring
• Support payer engagement activities involving Medicare, Medicare Administrative Contractors (MACs), Medicaid, Medicare Advantage, and commercial payers.
• Monitor national and regional payer policies, LCDs, medical policies, coding updates, and reimbursement changes affecting BioLab products.
• Research and help resolve reimbursement issues, policy questions, and complex claim challenges affecting providers, distributors, and customers.
• Escalate significant coverage or policy issues to senior leadership with supporting analysis and recommendations.
Coding, Billing & Pricing Support
• Support coding strategy activities, including research and coordination related to HCPCS, CPT, and ICD-10 pathways for new and existing products.
• Assist with billing and coding pathway development to promote accurate claims submission and compliant product utilization across sites of care.
• Coordinate ASP data collection, validation, and submission support processes to help ensure accuracy, timeliness, and regulatory compliance.
• Support pricing administration activities, including maintenance of AWP, WAC, RedBook updates, and related reimbursement files, in partnership with leadership and Finance.
• Help maintain product identifiers, including GTIN and UPC assignments, in accordance with internal standards and applicable data governance requirements.
Reimbursement Operations
• Manage day-to-day reimbursement support activities, including billing support, denial mitigation, appeals coordination, provider support, and reimbursement issue resolution.
• Establish and monitor workflows, service standards, and quality controls to improve clean claims, reduce avoidable denials, and support timely resolution of reimbursement issues.
• Track reimbursement performance metrics, denial trends, turnaround times, and team KPIs; identify improvement opportunities and implement corrective actions.
• Ensure reimbursement-related documentation and communications meet internal quality and compliance expectations.
Insurance Verification Oversight
• Supervise the in-house Insurance Verification team responsible for benefits investigation, eligibility verification, and related reimbursement support activities.
• Ensure insurance verification processes are completed accurately, consistently, and in accordance with HIPAA requirements, payer rules, and internal compliance standards.
• Implement training, quality review, and workflow improvements to support accurate verification outcomes and effective communication with internal teams and customers.
• Partner with reimbursement, billing, and commercial teams to support compliant and efficient downstream claims activity.
Leadership & Compliance
• Provide day-to-day supervision, coaching, training, and performance feedback for assigned team members.
• Support policies, procedures, and internal controls that promote compliance with CMS requirements, OIG guidance, HIPAA, and payer-specific billing and documentation requirements.
• Partner with Compliance and leadership to address risks, implement corrective actions, and maintain compliant reimbursement practices.
• Drive continuous improvement efforts that strengthen service delivery, process consistency, and reimbursement effectiveness.
This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job. Other duties may be assigned.
Minimum Qualifications
Education:
Bachelor's degree in business, Healthcare Administration, or a related field required.
Experience:
• 5-8 years of relevant experience in reimbursement, market access, revenue cycle, payer policy, or related healthcare operations roles required.
• Prior supervisory or people leadership experience preferred.
• Demonstrated experience with Medicare Part B reimbursement, biologic or specialty product access, and payer policy interpretation.
• Experience supporting HCPCS coding applications, reimbursement pathway development, and/or ASP reporting processes to CMS preferred.
• Experience overseeing or supporting reimbursement operations, appeals, denial mitigation, and/or insurance verification functions preferred.
• Experience in wound care, regenerative medicine, biologics, or buy-and-bill product environments strongly preferred.
Certifications:
Relevant healthcare reimbursement or coding certifications preferred but not required.
Knowledge, Skills, and Abilities
• Strong proficiency in medical terminology and healthcare reimbursement processes.
• Strong written and verbal communication skills with solid interpersonal effectiveness.
• Strong organization, follow-through, judgment, and time management skills.
• Ability to analyze reimbursement issues, recommend practical solutions, and escalate appropriately.
• Proficiency with Microsoft Office applications and relevant patient information, billing, or practice management systems.
• Working knowledge of EHR and EDI workflows and their role in billing, coding, and claim submissions.
• Ability to maintain confidentiality and handle sensitive information with professionalism and discretion.
Physical Requirements
• Ability to remain in a stationary position for extended periods of time while working on a computer.
• Ability to communicate effectively verbally and in writing.
• Ability to occasionally lift and/or move up to 15 pounds.
Work Environment
Employees in this role may be exposed to a variety of environmental, activity-related, and ergonomic hazards throughout the workday. Environmental risks include potential spills, weather-related
conditions, inadequate ventilation, exposure to extreme heat or cold, poor housekeeping, chemical exposure, and slip, trip, and fall hazards. Activity-related hazards may involve working around burn or heat sources, compressed gases, electrical cords and tools, energized equipment, and possible exposure to contagious diseases or other unforeseen risks. Ergonomic hazards are also present, including lifting, awkward postures, repetitive motions, and prolonged periods of sitting or standing. Specific job tasks such as sitting at a workstation for extended periods can lead to back, shoulder, hand, arm injuries, and eye strain, while prolonged standing may result in strains, sprains, and leg or knee injuries. Walking throughout the building introduces the risk of slips, trips, falls, and strains, particularly if walkways are obstructed or wet. Additionally, cleaning up spills can pose hazards such as slips, trips, strains, and potential exposure to bloodborne pathogens. Overall, employees must remain aware of these hazards to reduce the risk of injury in the workplace.
Travel Requirements
Occasional travel may be required for meetings, conferences, training, or customer support activities.
What we offer:Looking for a company to work for can be a daunting task, but we believe that we stand out from the rest. Our company offers a positive and inclusive work environment, opportunities for growth and development, and a commitment to work-life balance. Join us and become part of a team that values your contributions and invests in your success.
Employment Statement
The Company is an equal opportunity employer and complies with all applicable federal, state, and local employment laws. Employment decisions are made without regard to race, color, religion, sex,
national origin, age, disability, genetic information, veteran status, sexual orientation, gender identity, or any other status protected by applicable federal, state, or local law.
In accordance with the Americans with Disabilities Act, reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions or participate in the application process. Applicants needing accommodation should contact Human Resources.
Applicants must be legally authorized to work in the United States at the time of hire. The Company participates in employment eligibility verification as required by law.
The salary range for this position represents the anticipated compensation at the time of posting and may vary based on experience, qualifications, and geographic location where applicable.
Employment with the Company is at-will, meaning that either the employee or the Company may terminate employment at any time, with or without cause or notice, subject to applicable law.