Sr. Manager, Field Reimbursement

Sr. Manager, Field Reimbursement

Bio Tissue is seeking a Senior Manager to lead our Field Reimbursement team within the Market Access organization. This role bridges payers, providers, and patients to ensure timely and equitable access to Bio Tissue’s regenerative technologies.

This team serves as subject matter experts in payer policy, patient access, and provider support, helping to eliminate reimbursement barriers and optimize the treatment journey. The Sr. Field Reimbursement Manager partners with physician practices, including private clinics and hospital institutions, to support appropriate patient access and reimbursement processes.

The role engages directly with physicians, administrators, office staff and internally to deliver education and hands‑on support in clinical documentation, prior authorizations, claims submission and reconciliation, patient tracking, inventory management, and copay assistance. The manager also provides guidance on accurate coding and billing practices for Bio Tissue products, assists providers in identifying and addressing barriers that could delay or limit patient access, and ensures compliance with payer policies and standards.

• Partner with commercial team and third‑party support teams to remove barriers to patient access.
• Educate sales and healthcare providers on benefit verification, prior authorizations, patient cost‑share, and drug acquisition options.
• Lead scheduled calls, webinars, and virtual office hours on payer policies, denial trends, and reimbursement best practices.
• Act as the primary reimbursement resource for field reps, supporting proactive strategies to drive utilization and payer confidence.
• Collaborate with Market Access leadership to develop standardized tools (coding guides, payer updates, talking points).
• Guide coding, payer policies, claim approvals and appeals for denied or under‑paid claims.
• Monitor reimbursement trends and payer policy changes, escalating issues that may affect patient access.
• Lead business and claims reviews with leadership.
• Maintain knowledge of and build relationships with regional and national payer landscapes and prior authorization processes.
• Communicate policy updates clearly to customers and internal stakeholders.
• Uphold compliance with regulatory and ethical standards related to patient assistance programs.

• Bachelor’s degree in a related field;
  Master’s preferred.
• Minimum 5 years of experience in market access, specialty pharmaceuticals or surgical devices.
• At least 3 years of direct experience in reimbursement, payer policy, or healthcare policy.
• Experience in eyecare or ophthalmology is advantageous.
• Demonstrated expertise in physician‑administered injectables and/or medical devices, including Category III CPT codes, miscellaneous J‑codes, specialty pharmacy, buy‑and‑bill, benefit verification, prior authorizations, claims management and appeals.
• Experience navigating coverage and reimbursement with Medicare, Medicare Advantage, commercial and Medicaid plans.
• Strong understanding of provider reimbursement challenges and practice economics.
• Willingness and ability to travel (overnight ~60%) and participate in required trainings and meetings.
• Demonstrated leadership and project management skills.
• Experience educating healthcare professionals on patient support programs such as Co‑Pay Assistance and Patient Assistance Programs.

At Bio Tissue, we transform the gift of life by sharing miracles. We are a diverse community, where talent and teamwork are core to who we are. Here, you are empowered to do the work you love, be yourself, and make an impact.

Health, Dental, Vision Insurance; 401(k); FMLA;
Health Savings Account (HSA);
Flexible Spending Account (FSA);
Basic Life & AD&D Insurance;
Voluntary Life & AD&D Insurance;
Disability;
Employee Assistance Program (EAP);
Legal Shield/IDShield;
Pet Insurance;
Tuition Reimbursement;
Birthing & Parental Leave;
Paid Holidays;
Paid time off; MBO;
Stock options.

Candidates who cannot perform one or more of these requirements due to disability will be eligible for consideration based on whether the candidate can perform the position’s essential functions with reasonable accommodations.

Mid‑Senior level

Full‑time

Finance and Sales

Location:

Flagstaff, AZ