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About the Role
Heartflow is seeking a Field Reimbursement Manager to serve as a strategic partner to the commercial team, bringing reimbursement expertise to overcome access barriers. This fast-paced, field-embedded role is for individuals who thrive in ambiguity, influence without authority, and enjoy solving complex customer problems daily to ensure patient access to care.
Responsibilities
- Operate as the embedded reimbursement expert within the commercial field team, enabling sales success.
- Attend strategic customer calls to address complex coding, billing, and access concerns.
- Proactively partner with the Field Sales Team to identify facilities needing reimbursement support and develop strategies to address barriers.
- Educate the commercial team on coding updates, billing trends, and payer developments.
- Serve as the primary reimbursement support for providers and hospital billing and administrative leadership.
- Conduct onsite visits and remote consultations to educate customers on billing scenarios, documentation, and payment.
- Support customers across the full reimbursement cycle: pre-service authorization through post-service claims and appeals.
- Optimize prior authorization workflows and claims appeals processes.
- Partner with health system revenue cycle and finance teams to review and optimize chargemaster setup.
- Conduct claim reviews to identify patterns, provide recommendations, and ensure appropriate materials for reimbursement.
- Address and support customers in resolving patient coverage, access, and reimbursement questions.
- Identify gaps in customer-facing and internal educational resources and communicate needs.
- Monitor and communicate payer policy changes, CMS coverage determinations, and market access trends.
- Identify, anticipate, and surface systemic reimbursement opportunities and barriers.
- Maintain deep fluency in payer medical policies, prior authorization trends, and claims adjudication patterns across the Northeast.
Requirements
- Must live in one of the specified Northeast states (NY, CT, MA, ME, excluding Western Finger).
Skills
- Commercial Partnership Orientation
- Strategic Thinking
- Field Collaboration
- Executive Presence & Polish
- Operational Agility
- Revenue Cycle Mastery
- Policy Interpretation
- Market Intelligence
- Consultative Communication
- Data Proficiency
- Ethical Practice
Location
- Northeast Region (excluding Western Finger), NY, CT, MA, ME
Work Type
- Remote
- Field-based
- Full-time
Experience Level
- 5+ years of coding and billing experience managing both governmental and commercial claims
- Demonstrated customer-facing or education/training responsibilities
- Demonstrated experience in medical service coding and reimbursement
- Direct support of large health system or hospital billing optimization
- Proven experience operating alongside or embedded within a commercial sales organization
Education Level
- Bachelor's degree in a related field (Healthcare Administration, Business, or similar) preferred
- Equivalent combination of education and experience will be considered
- CPC (Certified Professional Coder), COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist) certification preferred
- RHIA or CHBME certification preferred
Salary/Compensations
- $90,000 to $120,000 per year plus bonus
About the Company
- Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease using AI-driven, non-invasive cardiac testing.
- The flagship product, Heartflow FFRCT Analysis, provides a 3D model of coronary arteries indicating the impact of blockages on blood flow.
- Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway.
- Heartflow is a publicly traded company (HTFL) recognized for healthcare innovation.
- The product is cleared for use in the US, UK, Europe, Japan, and Canada and has been used for over 750,000 patients worldwide.
Equal Opportunity
- Heartflow is an Equal Opportunity Employer.
- We are committed to a work environment that supports, inspires, and respects all individuals and do not discriminate against any employee or applicant because of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.
- This policy applies to every aspect of employment at Heartflow, including recruitment, hiring, training, relocation, promotion, and termination.