Field Reimbursement Manager - Southwest

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease using AI-driven, non-invasive cardiac testing. This field-embedded commercial role is for someone who thrives in ambiguity, earns trust with sales teams quickly, and pivots between complex customer problems daily. The Field Reimbursement Manager acts as a strategic partner to the commercial team, bringing reimbursement expertise as a solution to access barriers, not a gatekeeper. Remote, field based, with approximately 30% travel within the territory. Relocation assistance is not available currently. A reasonable estimate of the base salary compensation range is $90,000 to $120,000 per year and bonus.

Responsibilities

Operate as the embedded reimbursement expert within the commercial field team; 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; Partner with field team members and customers to serve as the primary reimbursement support for providers and hospital billing and administrative leadership; Conduct onsite visits and remote consultations to educate customers on appropriate billing scenarios, documentation requirements, and payment components; Support customers across the full reimbursement cycle from pre-service authorization through post-service claims and appeals; Partner with customers to optimize prior authorization workflows and claims appeals processes; Proactively partner with health system revenue cycle and finance teams to review and optimize chargemaster setup; Conduct claim reviews to identify patterns and provide recommendations to resolve issues; Address and support customers in resolving patient coverage, access, and reimbursement questions; Proactively identify gaps in customer-facing and internal educational resources; 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 Southwest

Requirements

5+ years of coding and billing experience managing both governmental and commercial claims, with demonstrated customer-facing or education/training responsibilities; Demonstrated experience in medical service coding and reimbursement, including direct support of large health system or hospital billing optimization; Proven experience operating alongside or embedded within a commercial sales organization (medical device, diagnostics, or specialty pharma strongly preferred); Must reside in TX, CO, AZ, NM, WY, or UT

Nice to have

Bachelor's degree in a related field (Healthcare Administration, Business, or similar); equivalent combination of education and experience will be considered; CPC, COC, or CCS certification; RHIA or CHBME certification; Prior experience in a medical device, diagnostics, or specialty pharma field reimbursement role; Familiarity with CMS NCD/LCD processes and commercial payer medical policy interpretation; Experience with cardiac or advanced imaging reimbursement, including radiology benefit manager prior authorization (e.g., Carelon, eviCore, Evolent); Working knowledge of the Southwest payer landscape, such as BCBS of Texas, Anthem Blue Cross Blue Shield (CO), BCBS of Arizona, BCBS of New Mexico, SelectHealth, and BCBS of Wyoming