Reimbursement Manager Western Region
- Posted: over a month ago
The Market Access Sr. Reimbursement Manager is responsible for coordination and execution of strategies to optimize market access and mitigate reimbursement barriers including reimbursement needs of the healthcare providers for TMS. The Market Access Sr. Reimbursement Manager will be responsible for providing reimbursement education to potential & some existing TMS Therapy providers, support the sales team from a coding and billing perspective, revenue cycle management and support business growth by ensuring TMS Therapy providers are properly educated on TMS Therapy. The position requires the ability to successfully navigate private office and provider network organizations, physician professional societies as well as facilitate smooth transitions for new clinical services from a reimbursement standpoint while developing solid health policy connections within the industry. The Market Access Sr. Reimbursement Manager will meet or exceed personal and company goals while achieving short and long-term company objectives and advocating for expanded market access and the refinement of reimbursement educational materials for TMS. This position is a strong customer-facing role and is a key partner to all levels of the sales team, marketing and customer service with the ability to travel up to 60% of the time.
- Support the sales team in educating potential customers and staff regarding revenue cycle management and proper coding and billing for TMS Therapy.
- Provide education and support to customers using Neuronetics reimbursement services.
- Assist new TMS Therapy providers with practice management issues associated with providing a new clinical service and establishing policies and procedures.
- Collect and communicate customer issues regarding TMS Therapy reimbursement management.
- Work with KOL advocates to address coding, coverage and payment limitations issues with payers.
- Coordinate and provide educational support for field sales on reimbursement issues relevant to prospective, new and some existing customers.
- Attend industry conventions, workshops, society & advocacy meetings to share learnings and to solidify relationships as it relates to reimbursement, health economics and health policy
- Identify and facilitate the development of physician reimbursement advocates for communication to payers.
- Provide guidance to prospective customers on the reimbursement processes as it relates to payer trends, medical necessity criteria, credentialing and the contract negotiation process.
- Work to provide ongoing improvement of reimbursement educational materials and services for potential and existing customers.
- Collaborates with sales team to ensure sales team members receive necessary reimbursement training on an on-going basis.
- Maximize development opportunities through continuous partnership – identification of key reimbursement trends in territories and sharing of information and knowledge.
- Manages key customer relationships, in an evolving business environment; frequently identifying reimbursement opportunities and best practices from customers that can be shared within and across the regions.
- Partner with cross-functional colleagues for the creation of new reimbursement materials and pull-through. Provide voice of customer and voice of field input on messages, tools, and compliance, and training needs to Marketing and Reimbursement training.
- Collaborates with the reimbursement team to identify the critical reimbursement hurdles and to support the team to address the issues.
- Participates in certain special projects, assigned activities, as and when appropriate; to include participation on advisory boards, new product opportunities and the like.
- Ethics and Compliance: Complies with all laws, regulations and company policies relevant to his/her responsibilities. Remains compliant with the budget guidelines provided by the Company relating to travel, entertainment and other expenses. Maintains superior knowledge of compliance requirements for both the company as well as within our industry. Partners with the Regulatory Affairs and Quality Assurance Department, Human Resources, Sales team and other members of the reimbursement team to ensure compliance.
- Other responsibilities, as necessary.
Knowledge, Skill, and Abilities:
- Detailed knowledge of credentialing, contracting, revenue cycle, coding, billing and payment systems for physician offices, and other health care settings.
- Ability to work cross-functionally with internal and field-based staff (sales, marketing, customer service).
- Knowledge of technology based medical services, medical policies and procedures.
- Excellent organization, planning, time management skills, and the ability to work independent without direct supervision.
- Excellent understanding of Medicare and private payer billing and coding, to include CPT, ICD-10, APC.
- Superb written and oral communication skills and ability to present effectively to all levels of private practice and hospital management and staff.
- Understanding of and compliance with HIPAA regulations.
- Computer proficiency including email/Outlook, Microsoft Office, and CRM systems.
- Unquestionably high ethical standards and track record of ethical behavior.
Education and Experience:
- Bachelor’s Degree in Science, Marketing, similar field or Nursing degree (or equivalent).
- 5+ years Life-Science and/or Medical Device reimbursement experience, preferably in companies where product is sold in some or all of the following:
- Outreach for physicians in the office or hospital setting.
- Consultation with product that has a disposable in the office setting.
- Presentations to staff in psychiatry.
- Experience working in a highly regulated industry and complying with strict regulations, policies and procedures.
- Pharmaceutical and/or Biotechnical background working in neurology, gastroenterology, rheumatology, dermatology, or oncology in an office or hospital setting
- Current Certified Professional Coder (CPC) status or equivalent
- Working knowledge of contracting for medical procedures with Medicare and commercial health plans
- Behavioral Health experience
- Standing/Sitting 30%
- Walking/Bending/Stooping 30%
- Travel by air, rail, auto (up to 60%)
*Applicants must be authorized to work for any employer in the US. We are unable to sponsor or assume responsibility for employment visa/work authorization at this time.
Neuronetics is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit
discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability,
genetic information, pregnancy or any other protected characteristic as outlined by federal, state, or local laws. This policy
applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall,
leave of absence, compensation, benefits, training, and apprenticeship. Neuronetics makes hiring decisions based solely on
qualifications, merit, business needs at the time.
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