MiMedx · 9 hours ago
Field Reimbursement Manager - Texas
Dallas, Texas, United States
Full-time
Hybrid
Entry, Mid Level
$106K/yr - $178K/yr
2+ years expMiMedx is dedicated to improving patient care through innovative regenerative biologics. The Field Reimbursement Manager will support a Regional Sales Team and customers in navigating the reimbursement landscape for MiMedx products, ensuring timely access and payment for services rendered.
BiotechnologyHealth CareMarketingMedicalMedical DeviceWellness
Responsibilities
Conduct training and education for new and existing customers on MiMedx Insurance Verification Request (IVR) process, billing, coding, place of service reimbursement, and national and local coverage policies by in-person meetings, email, phone, and WebEx
Serve as the primary reimbursement contact for a Regional Sales Team being the subject matter reimbursement expert
Work as liaison with provider accounts and field sales to provide information required to timely complete IVR cases with the Patient Insurance Verification Team (PIVT)
Provide Payer coverage and reimbursement updates to both internal and external customers
Follow-up with accounts to ensure proper payment of claims, identify any reimbursement issues, and work with the account to resolve
Investigate all denied or partially paid services and provide guidance regarding next steps and support needs
Conduct claim reimbursement reviews to monitor accurate payments; provide detailed analysis and identify billing errors
Meet or exceed quarterly Metric Based Objectives (MBO) pertaining to education and communication of reimbursement and coverage of MiMedx products
Conduct quarterly consignment product audits with Account Executives
Report changes in coverage/reimbursement trends and global concerns in this area to management to ensure corrective actions and mitigation of future occurrences
Troubleshoot national and local payer reimbursement issues
Adhere to HIPAA policies and procedures to ensure compliance
Adhere to the organization’s appeal strategy and manage its on-going tactical application to ensure a successful reversal rate
Qualification
Required
BS/BA in related discipline
2+ years of buy and bill medical benefit reimbursement experience
OR
MS/MA and 1-3 years of experience in related field. Certification is required in some areas
Familiarity with medical policy for insurance payers; Medicare, Medicaid, and Commercial
Strong understanding of CMS and final-rules and methodologies, experience with multiple places of service requirements, comprehension of Commercial Insurers (Aetna, Anthem Blue Cross Blue Shield, Cigna, Humana, United Health Care)
Strong understanding of medical coding including ICD10, CPT and HCPCS codes
Strong understanding of medical management and health insurance concepts, information systems and strong analytical and problem-solving skills
Excellent oral, written, and interpersonal communication skills
Ability to interact with all levels of management, both internal and external, third party payers, and customers
Organized, flexible, and able to multi-task while maintaining a high level of efficiency and attention to detail
Strong analytical skills, clinical interests, strategic and technical analysis and problem-solving skills
Ability to influence others to achieve desired results using tenacity and diplomacy
Fully competent and productive professional contributor, working independently on larger, moderately complex projects/assignments that have direct impact on department results
Preferred
Experience with Salesforce based CRM systems preferred
Prefer sales or account management experience
Benefits
Healthcare
401k savings plan
ESPP
Vacation
Parental leave
Company
MiMedx
MIMEDX is a pioneer and leader in the field of placental tissue.
501-1000 employees
Funding
Current Stage
Public CompanyTotal Funding
$266.36MKey Investors
Medical Technology Enterprise ConsortiumEssex Woodlands Healthcare PartnersHayfin Capital Management
2022-05-31Grant· $4.6M
2020-07-02Post Ipo Equity· $100M
2020-07-02Post Ipo Debt· $50M
Leadership Team
Doug Rice
Chief Financial Officer
Randall Spencer
VP of Product Innovation
Recent News
2026-01-09
2025-12-22
Company data provided by crunchbase