Job Description

Field Reimbursement Manager - Mid-Atlantic

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease, the #1 cause of death worldwide, using cutting-edge technology. The flagship productan AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFR CT Analysisprovides a color-coded, 3D model of a patient's coronary arteries indicating the impact blockages have on blood flow to the heart. Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMapAnalysis), assess coronary blood flow (FFR CT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). Our pipeline of products is growing and so is our team; join us in helping to revolutionize precision heartcare.

This is a high-impact, visible role where your expertise directly translates into patient access. You'll be instrumental in shaping our market presence and ensuring the successful adoption of a technology that is changing the standard of cardiovascular care. Join us and make a difference!

This role serves as the primary, expert consultant on all matters of coding, billing, and access for HeartFlow FFRct Analysis and other services. You will leverage your deep reimbursement experience to ensure our hospital and clinic partners succeed financially, while strategically aligning with our internal Sales Team.

This position will be a remote position with up to 30% travel throughout the US required.

Strategic Field Alignment & Consultation

• Act as the expert reimbursement partner embedded within the field team structure. Attend strategic sales calls to address complex coding and billing concerns, positioning Heartflow as a true consultative resource for customers.
• Collaborate with the Field Sales Team to proactively identify facilities and practices needing reimbursement education and support regarding Heartflow products.
• Educate the Sales Team on key coding updates, billing concerns, and reimbursement trends, ensuring the entire commercial team is strategically aligned and informed.
• Collaborate with the field facing "One Team" to compliantly share insights into customer needs, potential barriers, and payer issues/opportunities for patient access.

Customer Access & Billing Optimization

• Serve as the primary consultant for customer billing and administrative staff. Conduct calls or travel onsite to educate customers on the appropriate use of Category III codes, billing scenarios, and payment components.
• Provide comprehensive support throughout the full reimbursement cycle, from pre-service authorization to post-service collection.
• Support customers in optimizing their prior authorization workflow and claims appeals processes to maximize reimbursement success and minimize administrative burden.
• Conduct frequent claim reviews with practices to ensure appropriate reimbursement.
• Address and resolve patient coverage, access, and reimbursement questions from accounts, coordinating with patient services as directed by policy and procedure.

Content Strategy & Compliance

• Partner with Marketing to develop strategic educational materials (e.g., guides, presentations, FAQs) on coding, billing, and compliance for both customer and internal field team use.
• Identify, anticipate, and address patient and practice reimbursement issues by partnering with internal and external stakeholders.
• Maintain a deep understanding of Heartflow policies and industry trends to perform the role in a compliant manner consistent with company guidance.

Skills Needed:

• Deep Understanding of the Revenue Cycle: Expert knowledge of medical coding (CPT, ICD-10), payer policies, prior authorization workflows, and claims appeals processes.
• Policy Interpretation: Proven ability to interpret policies and medical necessity language to accurately identify appropriate documentation (e.g., ICD-10 codes, medical records) required for successful claim submission.
• Data Proficiency: Proficient in using the Microsoft Office Suite (Excel, Word, and PowerPoint), with advanced spreadsheet development skills for analysis and reporting.
• Cross-Functional Alignment: Proven ability to successfully collaborate and align with a direct sales force, serving as a respected consultative partner rather than a purely service-oriented resource. This requires a strategic mindset focused on enabling commercial success through access.
• Exceptional Communication: Outstanding presentation and communication skills, with the ability to translate complex reimbursement information into clear, actionable guidance for both internal teams and external customers.
• Ethical Practice: Unwavering commitment to ethical business practices and maintaining the highest level of compliance in all professional activities.

Educational Requirements & Work Experience:

• Greater than 5 years of demonstrated work experience in coding and billing managing both governmental and commercial claims reimbursement processes.
• Demonstrated medical service coding and reimbursement experience.
• Associates Degree in related field of study required.
• CPC preferred, COC preferred, cardiology experience a plus.
• Bachelor's degree preferred.

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 relocation.

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

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