Reimbursement Manager, Operations

1 week ago

Malvern, Pennsylvania, United States NeuroStar Full time

Reimbursement Manager, Operations

Location

US-PA-Malvern

ID

Category

Reimbursement

Position Type

Regular Full-Time

Overview

The Reimbursement Manager, Operations will be responsible for providing reimbursement education to new and existing TMS Therapy providers, support local sales team from a coding and billing perspective, and support business growth by ensuring TMS Therapy providers are properly educated on TMS Therapy. The position requires the ability to successfully navigate private office and hospital department organizations and facilitate a smooth transition of a new clinical service from a reimbursement standpoint. The Reimbursement Manager will meet or exceed personal and company goals while achieving short and long-term company objectives and assisting in the development and refinement of reimbursement educational materials to improve provider readiness to properly code for TMS. The RM position is a strong customer-facing role and is a key partner to all levels of the sales team and customer service with the ability to travel up to 50% of the time.

Essential Duties/Responsibilities:

  • Provide face to face customer education sessions with private practice and hospital management and staff to facilitate proper coding and billing for TMS Therapy.
  • Assist new TMS Therapy providers with practice management issues associated with providing a new clinical service and establishing policies and procedures.
  • Collaborate with Sales in resolving customer issues involving reimbursement for TMS Therapy.
  • Collect and communicate customer issues regarding TMS Therapy reimbursement management.
  • Coordinate and provide educational support for Sales on reimbursement issues relevant to prospects, new and existing customers.
  • Identify and facilitate the development of physician reimbursement advocates for communication to payers.
  • Provide guidance to new and existing customers on the reimbursement processes as it relates to payer trends, prior authorization process and the contract negotiation process.
  • Work to provide ongoing improvement of reimbursement educational materials and services for new and existing customers.
  • Collaborates with Sales to ensure sales team members receive necessary reimbursement training on an on-going basis.
  • Maximize territory development opportunities through continuous partnership - identification of key reimbursement trends in territories and sharing of information and knowledge.
  • Manages key customer relationships, in an evolving business environment; frequently identifying reimbursement opportunities and best practices from customers that can be shared within and across the regions.
  • Participates in certain special projects, assigned activities, as and when appropriate.
  • Support Sales and Training in-person at NeuroStar University and at miscellaneous customer-facing events by facilitating both large and small group presentations and discussions.
  • Provide valuable feedback from the field to the Senior Reimbursement Manager, Operations to help guide future departmental goals.
  • Work with the Senior Reimbursement Manager, Operations to coordinate departmental efforts that require key relationships from our practice partners.
  • Ethics and Compliance: Complies with all laws, regulations and company policies relevant to his/her responsibilities. Remains compliant with the budget guidelines provided by the Company relating to travel, entertainment and other expenses. Maintains superior knowledge of compliance requirements for both the company as well as within our industry. Partners with the Regulatory Affairs and Quality Assurance Department, Human Resources, Sales team and other members of the reimbursement team to ensure compliance.
  • Other responsibilities, as necessary.

Knowledge, Skill, and Abilities:

  • Detailed knowledge of coding, billing and payment systems for physician offices, inpatient hospitals, and outpatient hospitals.
  • Ability to work cross-functionally with internal and field-based staff (sales, marketing, customer service).
  • Knowledge of technology based medical services, medical policies and procedures.
  • Excellent organization, planning, time management skills, and the ability to work independent without direct supervision.
  • Excellent understanding of Medicare and private payer billing and coding, to include CPT, ICD-10, APC.
  • Excellent written and oral communication skills and ability to present effectively to all levels of private practice and hospital management and staff.
  • Understanding of and compliance with HIPAA regulations.
  • Computer proficiency including email/Outlook, Microsoft Office, and CRM systems.
  • Unquestionably high ethical standards and track record of ethical behavior.

Education and Experience:

  • Bachelor's Degree in Science, Marketing, similar field or Nursing degree (or equivalent).
  • 5+ years Life-Science and/or Medical Device reimbursement experience, preferably in companies where product is sold in some or all of the following:
    • Outreach for physicians in the office or hospital setting.
    • Consultation with product that has a disposable in the office setting.
    • Presentations to staff in psychiatry.
  • Experience working in a highly regulated industry and complying with strict regulations, policies and procedures.

Preferred Skills:

  • Pharmaceutical and/or Biotechnical background working in neurology, gastroenterology, rheumatology, dermatology, or oncology in an office or hospital setting
  • Current Certified Professional Coder (CPC) status or equivalent
  • Working knowledge of contracting for medical procedures with Medicare and commercial health plans
  • Behavioral Health experience

Physical Requirements

  • Standing/Sitting 30%
  • Walking/Bending/Stooping 30%
  • Travel by air, rail, auto (up to 50%)

*Applicants must be authorized to work for any employer in the US. We are unable to sponsor or assume responsibility for employment visa/work authorization at this time.

Neuronetics is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Neuronetics makes hiring decisions based solely on qualifications, merit, business needs at the time.

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