Director of Field Reimbursement (Req 1484)

Company Overview

Organogenesis (https://organogenesis.com/) is a leading regenerative medicine company focused on empowering healing through the development, manufacturing and sale of products for the advanced wound care market. Organogenesis' Advanced Wound Care division promotes a suite of products that are designed for the management and treatment of chronic and acute wounds in both inpatient and outpatient facilities.

Position overview

The Director of Field Reimbursement will operate as the leader and subject-matter expert on coding,
coverage, and payment issues related to the Organogenesis portfolio of products to the Field Reimbursement
Team.
The Director will have a comprehensive understanding of all aspects of reimbursement models (coding,
coverage, and payment), including complete understanding of Medicare A, B, C and D benefit designs, Medi-
gap, physician fee schedule and ability to locate applicable coverage policies Demonstrated advanced level
billing competencies including CPT, ICD-10, HCPCS coding and EOB interpretation. Ability to negotiate and
execute sophisticated/C-suite level site of care discussions related to various health care topics access and
reimbursement and able to set and pull through account level access strategies.

Products (click the link below for additional information on each product)

• Affinity
• Apligraf
• NuShield
• PuraPly
• Organogenesis Physician Solutions (OPS) products

Territory parameters

• Nationwide

Acceptable candidate location

• Nationwide- Boston preferred

Minimum requirements (required experience)

• Requires BS/BA degree
• 4+ years of medical billing/coding, medical/pharmaceuticals sales, hospital revenue cycle, or healthcare insurance/payer experience
• Demonstrate analytical, problem solving, critical thinking, and relationship-building skills.
• Excellent communication, organizational and leadership skills
• Ability to travel up to 40% (probably less) of the time. Face-to-Face interaction with customers preferred.
• AAPC billing/coding certification preferred.
• Must demonstrate a commitment to building strong relationships with customers.

Key Responsibilities

• Educate the Field Reimbursement Managers, HCPs, and their staff on matters related to coding, coverage, and payment to facilitate appropriate patient access to ORGO products.
• Responsible and accountable for the successful implementation nation-wide of the strategic and tactical
  reimbursement plan for Field Reimbursement Team.
• Provide direction on specific and actionable activities that can be fully executed and measured by the Field
  Based Reimbursement team.
• Assimilate and build customer facing tools for implementation by the Field Based Reimbursement team.
• Analyze reimbursement issues and act as the reimbursement resource for the field sales force personnel and commercial leadership.
• Lead and coordinate with all internal teams concerning individual patient cases and overall coordination with field reimbursement team, customers, and the field sales force.
• Collaborate cross functionally with Field Sales, Marketing, Payer/Policy, Senior Leadership, Sales Training, and Medical Affairs while abiding by all corporate and industry policy guidelines and procedures.
• Support key opinion leader development from a corporate perspective and provide targeted support
  to commercial sites of service to eliminate barriers to access.
• Coach and coordinate the training for analyzing provider claim forms for errors and provide recommended modifications.
• Teach how to analyze remittance advices for denied claims and guide the team through the appeal process for any denied claims.
• Act as mentor and escalation point for Benefit Verification/Benefit Assurance teams.
• Perform Business Reviews/Claims Analysis for providers.
• Reimbursement subject matter expert for the Field Reimbursement Team.
• Provide semi-annual/annual evaluations of the Field Reimbursement Team.
• Work with C-Suite personnel to educate on the benefits in the utilization of ORGO products to treat chronic and surgical wounds
• Recruit, hire, and train Field Reimbursement Managers.

Other Skills:

• Collaborates to build strategic vision and skills across the organization.
• Possesses strong consultative skills.
• Ability to manage multiple projects simultaneously.
• Proven problem-solving skills.
• Committed to working as a teammate.
• Proficient in MS Office.
• Exceptional written and verbal communication skills.
• Principled, honest, creative, enthusiastic, independent, curious, coachable, solution-minded.

Compensation & benefits

• Base salary: $175-200k
• Expected first-year earnings: $250-270k
• Auto: company car provided
• Fuel: gas card
• Expenses: business expenses covered
• Medical, dental, and vision insurance
• 401K with company match
• Vacation: 3 weeks per year; 12 holidays; 8 sick days
• Additional benefits include:
  • Short and long-term disability, employee assistance program, tuition assistance, employee referral bonus program, and more!