Field Reimbursement Manager - Mid-Atlantic

About the role

This is a fast-paced, field-embedded commercial role for someone who thrives in ambiguity, earns trust with sales teams quickly, and pivots between complex customer problems daily. You bring deep reimbursement expertise—but your real value is how you deploy it: as a strategic partner to our commercial team and a trusted advisor to providers and health systems.

Responsibilities

• Operate as the embedded reimbursement expert within the commercial field team—a trusted partner who enables sales success, not an oversight function.
• Attend strategic customer calls to address complex coding, billing, and access concerns, positioning Heartflow as a consultative resource.
• Prioritize identifying facilities needing reimbursement support and developing strategies to address barriers.
• Educate the commercial team on coding updates, billing trends, and payer developments, ensuring the entire field organization is aligned and informed.
• 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.
• Optimize prior authorization workflows and claims appeals processes, maximizing reimbursement success and reducing administrative burden.
• Partner with customers to review and optimize chargemaster setup, ensuring the services included on the CCTA pathway are accurately reflected for appropriate charge capture and reimbursement.
• Conduct claim reviews to identify patterns, resolve issues, and ensure appropriate reimbursement outcomes.
• Address and support customers in resolving patient coverage, access, and reimbursement questions in coordination with patient services and internal stakeholders.
• Proactively identify gaps in customer-facing and internal educational resources, communicating those needs internally to support timely content development.
• Monitor and communicate payer policy changes, CMS coverage determinations, and market access trends to keep Heartflow’s reimbursement guidance current and competitive.
• Identify, anticipate, and surface systemic reimbursement opportunities and barriers—bringing market intelligence back to the organization to inform strategy and response.
• Maintain deep fluency in payer medical policies, prior authorization trends, and claims adjudication patterns across the Mid-Atlantic region.

Qualifications

• Commercial Partnership Orientation (Priority)
• Patient First, Customer Support Mindset: Demonstrated ability to operate as a commercial enabler alongside a quota-carrying field sales team. Success is measured by account adoption and customer outcomes, not internal compliance metrics.
• Executive Presence & Polish: Credibility to represent Heartflow at the C-suite and health system leadership level. Ability to present confidently, handle objections on the spot, and command a room with both clinical and administrative audiences.
• Operational Agility: Demonstrated ability to manage multiple concurrent, time-sensitive priorities in a high-velocity environment. Comfort with daily reprioritization and ambiguity is essential.
• Technical Reimbursement Expertise: Revenue Cycle Mastery: Expert knowledge of medical coding (CPT, ICD-10-CM/PCS), payer policies, prior authorization workflows, and claims appeals processes across both governmental and commercial payers.
• Policy Interpretation: Proven ability to interpret CMS Local and National Coverage Determinations and commercial payer medical policies to accurately identify required documentation and guide billing strategy across any diagnostic modality.
• Market Intelligence: Ability to monitor, synthesize, and act on payer policy changes, coverage trends, and access barriers— and translate those insights into actionable guidance for customers and the internal commercial team.
• Communication & Collaboration: Consultative Communication: Outstanding ability to translate complex reimbursement concepts into clear, actionable guidance for internal commercial teams and external customer audiences at all levels.
• Data Proficiency: Proficient in the Microsoft Office Suite with advanced Excel skills for analysis, reporting, and customer-facing deliverables.
• Ethical Practice: Unwavering commitment to ethical business practices and compliance in all professional activities.

Skills Needed

• Commercial Partnership Orientation (Priority)
• Patient First, Customer Support Mindset: Demonstrated ability to operate as a commercial enabler alongside a quota-carrying field sales team. Success is measured by account adoption and customer outcomes, not internal compliance metrics.
• Executive Presence & Polish: Credibility to represent Heartflow at the C-suite and health system leadership level. Ability to present confidently, handle objections on the spot, and command a room with both clinical and administrative audiences.
• Operational Agility: Demonstrated ability to manage multiple concurrent, time-sensitive priorities in a high-velocity environment. Comfort with daily reprioritization and ambiguity is essential.
• Technical Reimbursement Expertise: Revenue Cycle Mastery: Expert knowledge of medical coding (CPT, ICD-10-CM/PCS), payer policies, prior authorization workflows, and claims appeals processes across both governmental and commercial payers.
• Policy Interpretation: Proven ability to interpret CMS Local and National Coverage Determinations and commercial payer medical policies to accurately identify required documentation and guide billing strategy across any diagnostic modality.
• Market Intelligence: Ability to monitor, synthesize, and act on payer policy changes, coverage trends, and access barriers— and translate those insights into actionable guidance for customers and the internal commercial team.
• Communication & Collaboration: Consultative Communication: Outstanding ability to translate complex reimbursement concepts into clear, actionable guidance for internal commercial teams and external customer audiences at all levels.
• Data Proficiency: Proficient in the Microsoft Office Suite with advanced Excel skills for analysis, reporting, and customer-facing deliverables.
• Ethical Practice: Unwavering commitment to ethical business practices and compliance in all professional activities.

Required Educational Requirements & Work Experience

• 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 be located in or able to relocate to DC, MD, PA, or surrounding Mid-Atlantic states (relocation assistance not available at this time).

Preferred

• Bachelor’s degree in a related field (Healthcare Administration, Business, or similar); equivalent combination of education and experience will be considered.
• CPC (Certified Professional Coder) or COC (Certified Outpatient Coder) 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.

Pay

A reasonable estimate of the base salary compensation range is $90,000 to $120,000 per year and bonus.

Schedule

This position is remote, however, you must be located in one of the following states as listed or be able to relocate. Please note, at this time, we are not able to sponsor re-location. A reasonable estimate of the base salary compensation range is $90,000 to $120,000 per year and bonus.