MAJOR DUTIES AND RESPONSIBILITIES- Provide reimbursement education and day-to-day support to eye care practices, billing teams, administrators, and internal field partners within the assigned territory.
- Explain approved information related to coding, coverage, documentation, claims submission, payment pathways, and reimbursement processes. Do not provide legal advice, guarantee coverage or payment, or direct a provider's clinical or billing decisions.
- Assist accounts in identifying common reimbursement barriers and appropriate next steps, including use of available payer policies, claim forms, remittance information, and approved support resources.
- Coordinate with internal reimbursement, patient access, customer service, and sales partners to support timely follow-up on account questions and unresolved issues.
- Conduct virtual and in-person customer education using company-approved presentations, tools, and materials.
- Maintain accurate, timely documentation of customer interactions, issue status, follow-up commitments, and field trends in approved company systems.
- Identify recurring coding, coverage, billing, or payment themes and escalate them to Market Access leadership for review and prioritization.
- Support onboarding and education of sales partners on reimbursement resources, approved messaging, escalation pathways, and compliant customer support practices.
- Build productive working relationships with healthcare providers, office managers, billing personnel, and other account stakeholders in the assigned region.
- Participate in regional meetings, customer programs, and internal training as requested.
- Stay current on relevant reimbursement resources, Medicare and commercial payer processes, and company products through ongoing training and direction from Market Access leadership.
- Complete assigned projects and administrative responsibilities on time, including expense reporting, training, CRM documentation, and required compliance activities.
- Carry out all duties in accordance with company policies, procedures, and applicable laws and regulations governing business practices.
QUALIFICATIONS EDUCATION REQUIREMENTS- Bachelor's degree in healthcare administration, business, life sciences, health policy, health economics, or a related field preferred. Relevant experience may be considered in place of a degree.
EXPERIENCE REQUIREMENTS- Minimum of 2 years of experience in reimbursement, patient access, medical billing, coding, revenue cycle, payer services, healthcare customer support, medical device, pharmaceutical, or a related healthcare setting.
- Basic working knowledge of U.S. healthcare reimbursement, including public and commercial payers, claims processing, coding, coverage, and payment concepts.
- Experience communicating with healthcare providers, office staff, billing teams, patients, payers, or other healthcare stakeholders.
- Experience managing multiple customer questions or cases, documenting activity, and completing follow-up within established timelines.
- Experience in using Microsoft Office and a CRM or case-management system preferred.
OTHER QUALIFICATIONS- Clear, professional written and verbal communication skills, including the ability to explain reimbursement concepts in practical, easy-to-understand language.
- Strong organization, attention to detail, follow-through, and customer-service orientation.
- Ability to work independently in a field-based environment while seeking guidance and escalating issues appropriately.
- Ability to collaborate effectively with Sales, Market Access, Patient Access, Customer Service, Legal, and Compliance partners.
- Comfort presenting to small groups and conducting virtual or in-person educational discussions.
- Sound judgment and commitment to compliant, accurate, and non-promotional reimbursement support.
- Ability to manage changing priorities and learn new products, processes, policies, and systems.
PHYSICAL DEMANDS- Sitting and computer work for extended periods; frequent telephone and virtual customer interaction.
- Ability to travel to physician offices, healthcare facilities, company meetings, and customer programs as required.
- Ability to transport standard business materials and equipment associated with field-based work.
TRAVEL REQUIREMENTS- Domestic travel of up to 30% is expected, based on business and territory needs.
NOTEThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts, or working conditions associated with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, variation in workload, rush jobs, or technological developments).
