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HeartFlow

Non-invasive cardiac imaging to guide treatment

Field Reimbursement Manager

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • At least 5 years of coding and billing experience managing both governmental and commercial claims, with customer-facing or education/training responsibilities.
  • Demonstrated experience in medical service coding and reimbursement, including direct support of large health system or hospital billing optimization.
  • Proven experience operating alongside or embedded within a commercial sales organization; experience in medical devices, diagnostics, or specialty pharma is strongly preferred.
  • Must live in or be able to relocate to New York, Connecticut, Massachusetts, or Maine.
  • Strong strategic thinking, territory prioritization, and planning ability.
  • Demonstrated success partnering with a quota-carrying field sales team to remove access barriers and improve patient access.
  • Ability to represent Heartflow credibly with C-suite and health system leaders, present confidently, handle objections, and engage clinical and administrative audiences.
  • Ability to manage multiple concurrent, time-sensitive priorities and adapt to reprioritization and ambiguity.
  • Expert knowledge of medical coding, including CPT and ICD-10-CM/PCS, payer policies, prior authorization workflows, and claims appeals processes across governmental and commercial payers.
  • Ability to interpret CMS Local and National Coverage Determinations and commercial payer medical policies to identify documentation requirements and guide billing strategy across diagnostic modalities.
  • Ability to monitor, synthesize, and act on payer policy changes, coverage trends, and access barriers, translating insights into guidance for customers and internal commercial teams.
  • Ability to translate complex reimbursement concepts into clear, actionable guidance for internal commercial teams and external customers.
  • Proficiency in Microsoft Office Suite and advanced Excel skills for analysis, reporting, and customer-facing deliverables.
  • Commitment to ethical business practices and compliance.
  • Preferred: bachelor's degree in a related field such as Healthcare Administration or Business; equivalent education and experience will be considered.
  • Preferred: CPC, COC, or CCS certification.
  • Preferred: RHIA or CHBME certification.
  • Preferred: familiarity with CMS NCD/LCD processes and commercial payer medical policy interpretation.
  • Preferred: experience with cardiac or advanced imaging reimbursement, including radiology benefit manager prior authorization.
  • Preferred: working knowledge of the Northeast payer landscape.

Responsibilities

  • Operate as the embedded reimbursement expert within the commercial field team, enabling sales success as a trusted partner rather than an oversight function.
  • Attend strategic customer calls to address complex coding, billing, and access concerns, positioning Heartflow as a consultative resource.
  • Partner proactively with the Field Sales Team to identify facilities that need reimbursement support and develop strategies to address barriers.
  • Educate the commercial team on coding updates, billing trends, and payer developments to keep the field organization aligned and informed.
  • Provide primary reimbursement support to providers and hospital billing and administrative leaders in partnership with field team members and customers.
  • Conduct onsite visits and remote consultations to educate customers on billing scenarios, documentation requirements, and payment components.
  • Support customers throughout the reimbursement cycle, from pre-service authorization through post-service claims and appeals.
  • Partner with customers to optimize prior authorization workflows and claims appeals processes to improve reimbursement success and reduce administrative burden.
  • Partner with health system revenue cycle and finance teams to review and optimize chargemaster setup for accurate charge capture and reimbursement on services in the cCTA pathway.
  • Conduct claim reviews to identify patterns, recommend issue resolution, and ensure appropriate materials are aligned for reimbursement outcomes.
  • Support customers in resolving patient coverage, access, and reimbursement questions with patient services and internal stakeholders.
  • Identify gaps in customer-facing and internal educational resources and communicate needs to support timely content development.
  • Monitor and communicate payer policy changes, CMS coverage determinations, and market access trends to keep reimbursement guidance current and competitive.
  • Identify, anticipate, and surface systemic reimbursement opportunities and barriers, bringing market intelligence to the organization to inform strategy and response.
  • Maintain fluency in payer medical policies, prior authorization trends, and claims adjudication patterns across the Northeast, including NGS (Jurisdiction K), major regional commercial plans, and radiology benefit managers.

Desired Qualifications

  • Experience in medical devices, diagnostics, or specialty pharma is strongly preferred.
  • Prior experience in a medical device, diagnostics, or specialty pharma field reimbursement role.
  • Experience with cardiac or advanced imaging reimbursement, including radiology benefit manager prior authorization such as Carelon, eviCore, or Evolent.
  • Working knowledge of the Northeast payer landscape, including plans such as Empire/Anthem, Excellus, Emblem Health, BCBS of Massachusetts, or Point32Health.
  • Bachelor's degree in a related field such as Healthcare Administration or Business; equivalent education and experience will be considered.
  • CPC, COC, or CCS certification.
  • RHIA or CHBME certification.
  • Familiarity with CMS NCD/LCD processes and commercial payer medical policy interpretation.

About the Company

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HeartFlow

Non-invasive cardiac imaging to guide treatment

HeartFlow provides a non-invasive cardiac test that helps doctors visualize a patient’s coronary arteries to diagnose and plan treatment for heart disease. It uses a proprietary set of analyses—FFRCT Analysis, RoadMap Analysis, Plaque Analysis, and HeartFlow Planner—to create a detailed, patient-specific visualization from imaging data, enabling clinicians to assess blood flow and plaque without surgery. This approach reduces the need for invasive procedures, lowers risk for patients, and can cut costs for healthcare providers. Compared with traditional methods, HeartFlow offers validated, FDA-cleared tools that integrate multiple analyses into one platform, giving physicians a clearer, data-driven basis for diagnosis and treatment decisions. The company’s goal is to improve cardiovascular care by making safer, more efficient diagnosis and treatment planning widely available in hospitals and clinics around the world.

Company size
501-1,000
Company stage
IPO
Headquarters
San Francisco, CA
Founded
2010

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