About Heartflow

Role and Responsibilities

Strategic Field Alignment & Consultation

• Act as the expert reimbursement partner embedded within the field team structure by attending strategic sales calls to address complex coding and billing concerns, positioning Heartflow as a consultative resource for customers.
• Collaborate with the Field Sales Team to proactively identify facilities and practices needing reimbursement education and support regarding Heartflow products.
• Educate the Sales Team on key coding updates, billing concerns, and reimbursement trends to ensure commercial team alignment and information sharing.
• Collaborate with the field-facing "One Team" to compliantly share insights on customer needs, potential barriers, and payer issues/opportunities for patient access.

Customer Access & Billing Optimization

• Serve as the primary consultant for customer billing and administrative staff, conduct calls or travel onsite to educate customers on Category III codes, billing scenarios, and payment components.
• Provide support throughout the reimbursement cycle, from pre-service authorization to post-service collection.
• Support customers in optimizing prior authorization workflow and claims appeals processes to maximize reimbursement success and minimize administrative burden.
• Conduct frequent claim reviews with practices to ensure appropriate reimbursement.
• Address and resolve patient coverage, access, and reimbursement questions from accounts, coordinating with patient services as per policy and procedure.

Content Strategy & Compliance

• Partner with Marketing to develop strategic educational materials on coding, billing, and compliance for customers and internal field team use.
• Identify, anticipate, and address patient and practice reimbursement issues by partnering with internal and external stakeholders.
• Maintain deep understanding of Heartflow policies and industry trends to perform the role in a compliant manner consistent with company guidance.

Skills Needed

• Deep Understanding of the Revenue Cycle: Medical coding (CPT, ICD-10), payer policies, prior authorization workflows, and claims appeals processes expertise.
• Policy Interpretation: Ability to interpret policies and medical necessity language to identify appropriate documentation for claim submission.
• Data Proficiency: Proficient in Microsoft Office Suite (Excel, Word, PowerPoint) with advanced spreadsheet development skills.
• Cross-Functional Alignment: Ability to collaborate and align with a sales force as a consultative partner, enabling commercial success through access.
• Exceptional Communication: Strong presentation and communication skills to translate complex reimbursement information into clear guidance.
• Ethical Practice: Commitment to ethical business practices and compliance.

Educational Requirements & Work Experience

• More than 5 years of work experience in coding and billing managing governmental and commercial claims reimbursement processes.
• Medical service coding and reimbursement experience.
• Associate's Degree in a related field required.
• CPC and COC certifications preferred, cardiology experience is a plus.
• Bachelor’s degree preferred.

Additional Information

Equal Opportunity Employer