Field Reimbursement Manager - Northeast

This position is open for the Northeast Region (excluding Western Finger), NY, CT, MA, ME *Must live in one of these States

At Heartflow, our Field Reimbursement Managers are strategic partners to our commercial team, bringing reimbursement expertise as a solution to access barriers, not a gatekeeper. If you are energized by solving novel access challenges in real time, comfortable influencing without authority, and frustrated by slow, process-heavy environments, this role was built for you.

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. Every coverage barrier you remove means a patient gets a fast, noninvasive answer about their coronary artery disease instead of a delay or an unnecessary invasive procedure. You bring deep reimbursement expertise and deploy it with judgment: anticipating access barriers before they stall an account and building plans with your sales partners.

This is a high-impact, highly visible position. Your expertise translates directly into patient access and commercial momentum. Join Heartflow and make a difference.

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.

Educational Requirements & Work Experience

Required

• 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 in or able to relocate to states

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), COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist) 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
• Experience with cardiac or advanced imaging reimbursement, including radiology benefit manager prior authorization (e.g., Carelon, eviCore, Evolent)
• Working knowledge of the Northeast payer landscape, such as [e.g., Empire/Anthem, Excellus, Emblem Health, BCBS of Massachusetts, Point32Health]

Location, Travel, and Compensation

Remote, field based position. Must live within the Northeast region. Relocation assistance is not available currently. Approximately 30% travel within the territory.

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

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