Area Reimbursement Manager

SI-BONE, IncRemote - Chicago, IL (Remote)$125k – $135k2d ago

Remote Senior NA Insurance Payments Community Manager Physician Excel Salesforce Training Development Reporting Case Management

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Requirements

Bachelor’s degree or equivalent experience
Minimum of 5 years of experience in reimbursement activities with a medical device or pharma company
Direct experience with Medicare Transitional Pass-Through (TPT) and New Technology Add-On Payment (NTAP) preferred
Previous coding and billing experience in an office, hospital, ASC setting preferred
Experience in Medical Device Industry preferred
Expertise and Attributes:
A strong understanding of medical device reimbursement coding, coverage and payment processes and practices
Available to travel as needed
Customer focused individual
Thorough knowledge of reimbursement
Demonstrated success in handling a reimbursement region with another medical device company
Experience in development of medical coverage policies and gaining favorable coverage decisions with government and commercial payors
High level of interpersonal skills: influencing, resolving conflict, and creative problem solving. Must be an excellent communicator using all available channels
Ability to make effective presentations to cross functional areas of the company, and to outside healthcare professionals and payors
A history of successfully managing relationships at all levels of the organization
Strong organizational skills, ability to prioritize and complete projects
Effective analytical and problem-solving skills with the ability to handle multiple projects and apply creative solutions to challenges
Possess a high level of energy and collaborative management style
Demonstrated proficiency with Word, Excel, PowerPoint and Salesforce.com
Ability to work in a fast-paced, thinly resourced organization
Knowledge and familiarity of applicable regulations/standards (e.g. ISO 13485, FDA 21 CFR 820, EU MDR 2017/745, ISO 14971) as required to perform the job function

Responsibilities

Reports to Area Reimbursement Director
Acts as the internal expert and resource on coding and reimbursement for SI-BONES product portfolio
Provide effective collaboration between the reimbursement team, sales organization and physicians/surgeon’s offices to develop case reimbursement strategies in attempts to secure coverage for iFuse system implantation
Build collaborative relationships with Territory and Regional sales representatives to prioritize and optimize reimbursement support services in the region
Interface and collaborate with governmental reimbursement entities (Medicare, Medicaid, TRICARE, etc.) and commercial payors in assigned region
Collaborate with marketing, clinical, regulatory, and sales teams concerning ongoing operation’s needs
The Area Reimbursement Manager must act and conduct company business in an honest, ethical and lawful manner, consistent with the company’s Code of Conduct, other company policies and the AdvaMed Code of Conduct and/or any other applicable industry code(s) of conduct. The company does not tolerate retaliation in connection with making good faith reports of suspected violations.
Responsible for performing all duties in compliance with all applicable worldwide regulatory requirements as included in the scope of the SI-BONE Quality Manual
Execute case management appeal activities to ensure optimal opportunity for successful overturn of denied iFuse claims by providers to support education on medical necessity – either physician/surgeon and/or facility, i.e., inpatient, outpatient, office-based lab, and ambulatory surgery center
Provide subject matter expertise regarding payors and coverage
Execute payor relations activities to yield favorable coverage decisions
Proactively seek out payor presentation opportunities
Participate in development of reimbursement presentation and training materials relative to physician users and payor decision-makers with relevant internal stakeholders
Execute coding strategy for all sites of care
Visit surgeon’s offices in person or virtually to provide overview of Patient Insurance Case Support program and resource offerings,
Represent the company at medical conferences, physician, payor, tradeshows and company meetings as SI Bone’s reimbursement expert, as appropriate
Collaborate and communicate regularly with reimbursement team and sales teams
Delivers clear messages that are disseminated to SI-BONE leadership regarding payor trends, reimbursement changes, and billing & documentation requirements relating to SI-BONE products
Support the SI-BONE Quality System
Other duties as assigned

Benefits

Supplemental pay: bonus and stock
There are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit. For additional information on the company or the products including risks and benefits, please visit www.si-bone.com/risks.
We are aware of active recruitment scams using the SI-BONE name, in which individuals pose as our recruiters and post fake remote job openings and make fake job offers on the Internet. Please note, we will never make an offer of employment without conducting multiple rounds of interviews face-to-face using secure video-conferencing technology. We will never ask candidates to cash checks or make a payment in order to be considered for a position. SI-BONE only uses company email addresses, which contain “@si-bone.com” to communicate with candidates.
If you believe you’ve been a victim of a phishing scam, please visit the Cybersecurity & Infrastructure Security Agency at https://www.cisa.gov/be-cyber-smart/report-incident learn how to report it.