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Salary: USD 90,000 - 120,000 / annual
HeartFlow is a publicly traded medical technology company (HTFL) advancing the diagnosis and management of coronary artery disease using AI-driven, non-invasive cardiac testing. The flagship product—HeartFlow FFR_CT Analysis—provides 3D models of coronary arteries to help clinicians identify blockages and assess blood flow impact. The company has been used for over 750,000 patients worldwide and is cleared for use in the US, UK, Europe, Japan, and Canada.
This Field Reimbursement Manager role is embedded within the commercial field team for the Northeast Region (NY, CT, MA, ME). You will serve as a strategic reimbursement partner to the sales organization, solving access barriers in real time and enabling patient access to HeartFlow's diagnostic solutions.
Key Responsibilities:
Strategic Field Partnership: Operate as the embedded reimbursement expert within the commercial field team—a trusted partner who enables sales success rather than functioning as an oversight resource. Attend strategic customer calls to address complex coding, billing, and access concerns. Proactively identify facilities needing reimbursement support and develop strategies with the field sales team. Educate the commercial team on coding updates, billing trends, and payer developments.
Customer Access & Billing Optimization: Serve as primary reimbursement support for providers and hospital billing/administrative leadership. Conduct onsite visits and remote consultations 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 health system revenue cycle and finance teams to optimize chargemaster setup. Conduct claim reviews to identify patterns and provide recommendations. Address patient coverage and reimbursement questions in coordination with internal stakeholders.
Market Intelligence & Education: Monitor and communicate payer policy changes, CMS coverage determinations, and market access trends. Identify systemic reimbursement opportunities and barriers, bringing market intelligence back to inform organizational strategy. 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.
Required Qualifications:
- 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 able to live in or relocate to NY, CT, MA, or ME
Preferred Qualifications:
- Bachelor's degree in Healthcare Administration, Business, or related field (equivalent combination of education and experience considered)
- CPC (Certified Professional Coder), COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist) certification
- RHIA or CHBME certification
- Prior experience in 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 Northeast payer landscape (e.g., Empire/Anthem, Excellus, Emblem Health, BCBS of Massachusetts, Point32Health)
