Reimbursement Manager- Remote

Overview

MTF Biologics processes tissue grafts from human donors that are used in a growing array of clinical applications – positively affecting lives across the globe. As a global nonprofit organization that saves and heals lives by honoring donated gifts and serving patients, we collaborate with the medical, scientific, as well as organ and tissue donation communities.

Reporting to the Senior Director of Health Policy and Government Affairs, the Reimbursement Manager will be responsible for the daily management of reimbursement support services of the product portfolio. The incumbent will also act as the organization’s reimbursement liaison between sales staff and providers and must be willing to travel at least 30% of the time, with some weekend travel required.

South Plainfield, NJ | $60,000 – $120,000 per year

• Support the Senior Director of Health Policy and Government Affairs in fielding and responding to coding, coverage, and reimbursement internal inquiries and providing policy research assistance.
• In coordination with sales and marketing staff, lead on-site customer meetings (e.g., physicians & hospital medical professionals, purchasing & revenue departments, billing/coding staff) to provide coding and reimbursement education & assistance and address any reimbursement challenges.
• Manage third‑party reimbursement support services – monitoring and analyzing casework for payer coverage trends and assisting with challenging cases and claims’ appeals.
• Create internal educational materials and customer collateral (coding and reimbursement guides, etc.).
• Prepare and submit Medicare Part B ASP data quarterly to CMS.

• Education:
  
  Bachelor’s Degree.
• Degree in Health Care Administration, Public Health, Public Policy, Public Administration, Finance, Business, Marketing, Communications, or related field.
• 3–5 years of experience in a related field (e.g., tissue banking, medical device manufacturing, pharmaceutical or biologicals industry, healthcare reimbursement support services, or health policy).

• Solid understanding of Medicare and Medicaid programs and their payment methodologies, including coverage development, coding, and reimbursement of allografts (e.g., tissue matrices/skin substitutes, musculoskeletal tissues) used in wound care, plastic & reconstructive, and orthopedic procedures across all care settings.
• Previous experience working with sales, marketing, clinical, regulatory, and R&D teams to support product launches and educate sales staff and external customers on current and future product coding and reimbursement.
• Track record of developing and delivering product value through presentations to varied audiences for products with limited payer coverage & reimbursement.

Preferred:
Certified Professional Coder (CPC), Certified Professional Biller (CPB), or Certified Billing and Coding Specialist (CBCS).

• Experience with tissue matrices/skin substitutes used in wound care and surgical interventions as well as allografts used in plastic & reconstructive and orthopedic procedures.
• Ability to work independently with demonstrated self‑initiative, capacity to research and stay current on managed care and healthcare industry trends.
• Strong presentation skills with ability to articulate and present complex information in a simple and persuasive manner.
• Outstanding problem‑solving, project/program management, and organizational skills.
• Proficiency in MS Office (Word, Excel, PowerPoint, Outlook, etc.).

• 4 weeks Paid Time Off (PTO)
• Paid Holidays
• Medical, Dental, Vision Insurance and Prescription Drug Insurance
• 401(K) plan with company match
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Adoption Assistance
• Voluntary Benefits (e.g., Pet Insurance, Legal, home and auto insurance)
• Sword Health (at‑home Physical Therapy)

Referrals increase your chances of interviewing at MTF Biologics by 2x.