The Manager, Patient Access is responsible for providing compliant reimbursement education and support to healthcare providers and patients regarding the Barricaid device. Reporting to the National Director, Patient Access, this role requires deep knowledge of U.S. reimbursement policies and market conditions to remove financial barriers for customers. The manager will interact with a diverse customer base, including physicians, hospital staff, and patients
Primary Duties:
- Customer reimbursement support: Field inbound and outbound calls from patients and providers to provide education on coding, coverage, and reimbursement processes for Barricaid. This includes conducting benefit investigations, obtaining prior authorizations, and providing tactical support for the appeals process.
- Payer relations and strategy: Monitor and anticipate changes in public and private payer policies and build relationships with payer stakeholders to secure favorable coverage. The manager will also develop compliant reimbursement strategies and tactics in coordination with leadership.
- Market analysis and reporting: Develop ad hoc and timely reports on customer activity, payer trends, and market developments impacting Barricaid. Participate in tactical planning with Patient Access leadership.
- Customer education: Identify unmet educational needs among key accounts and collaborate with Field Reimbursement to address them. Assist in developing reimbursement materials and tools for customers and the field team.
- Operational improvements: Critically evaluate existing procedures and practices and develop and implement improvements to enhance claims processing and overall efficiency.
- Record-keeping and compliance: Maintain accurate records of all customer activities in the company CRM. Ensure all interactions and data handling comply with HIPAA regulations.
Critical Knowledge, Skill, Education, and Abilities:
- Bachelor's degree or equivalent experience required
- 5+ years of reimbursement experience in medical device or pharmaceutical/biotech
- Demonstrated knowledge of local payer, reimbursement and access and provider landscape. Strong understanding of insurance and benefit design with both commercial and government payers
- Demonstrated experience with addressing product access, reimbursement and/or transition of care issues
- Excellent working knowledge of Microsoft Word, Outlook, Excel and PowerPoint
- Experience working with medical-benefit plans preferred
- Demonstrated strong interpersonal, communication and relationship-building experience
- Knowledge of industry dynamics and strategic planning orientation
- May live anywhere in the contiguous United States
Pay: $75,000.00 - $85,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible schedule
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Tuition reimbursement
- Vision insurance
Experience:
- Reimbursement in Med Device / Pharma / Biotech: 5 years (Required)
- Prior Authorization in Med Device : 5 years (Preferred)
- Prior Authorization and Claim Appeals Process: 5 years (Preferred)
Willingness to travel:
Work Location: Remote
