Field Reimbursement Manager - Northeast

Who Thrives Here

You will thrive here if you:

• Think in terms of territory strategy, not just the next call — prioritizing cross functional partnerships and troubleshooting as a path for patient access
• Spot patterns across accounts, such as a denial trend or a prior authorization bottleneck, and act before they become escalations
• See your sales partners' success and patient access as the same goal, and earn their trust by solving problems with them
• Own issues from start to finish, from pre-service authorization through appeal outcome, and close the loop every time
• Present confidently to hospital CFOs, health system administrators, and clinical leadership alike
• See ambiguity as interesting, not threatening
• Can translate a complex payer policy into plain language on a live customer call without preparation time
• Have operated successfully alongside a quota-carrying field sales team — not as a compliance resource, but as a trusted commercial partner
• Understand supporting a team is a valued partnership

What You Will Own

Strategic Field Partnership

• 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
• 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, ensuring the entire field organization is aligned and informed

Customer Access & Billing Optimization

• 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, maximizing reimbursement success and reducing administrative burden
• Proactively partner with health system revenue cycle and finance teams 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, provide recommendations to resolve issues, and ensure appropriate materials aligned for reimbursement outcomes
• Address and support customers in resolving patient coverage, access, and reimbursement questions in coordination with patient services and internal stakeholders

Market Intelligence & Education

• 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 Northeast, including NGS (Jurisdiction K), major regional commercial plans, and radiology benefit managers

Skills Needed

Commercial Partnership Orientation (Priority)

• Strategic Thinking: Ability to see the territory, prioritize where reimbursement support will have the greatest impact, and plan rather than react.
• Field Collaboration: Demonstrated success working alongside a quota-carrying field sales team as a trusted partner who removes access barriers and improves patient access.
• 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.