Boston Scientific Senior Field HEMA Manager 

United States, Massachusetts, Marlborough 

403960141

Your responsibilities will include:

• The field-based position conducts training and education for FRMs on pertinent issues and changes within the payer systems.
• Supports FRM team as a point of escalation for specific account needs and complex issues.
• Aligns with CMS efforts and data analytics to support knowledge and decision-making efforts as it applies to our technologies.
• Consults with HEMA department on internal projects.
• Leads efforts on specific projects to address reimbursement related outcomes for the advancement of BSC technologies.
• Designs HEMA collateral for customer and field education use.
• Presentations for physician education at courses and/or conferences; as well as develops reimbursement review concepts for physician offices, LUGPAs, hospitals, or ASCs.
• Follows HIPAA policies and procedures to ensure protected health information is secure and not accessible to employees not authorized to view the information.
• Adheres to the organization’s appeal strategy and manages the on-going tactical application of the appeal strategy to ensure a successful reversal rate in conjunction with the Urology Procedure Access Program.
• Collaborates with functional colleagues to inform strategic activities related to health economic research, health policy and business development.
• Support senior leadership to ensure health economics and reimbursement data are incorporated into product development/business strategies and timelines
• Completes all other job duties as assigned.

Minimum qualifications

• Bachelor’s degree in economics, finance, marketing, business, public health, or related field and at least 10 years of professional experience.
• 8+ years of experience in coding, coverage and reimbursement including insurance verifications, appeals submissions and resolution, billing/claims processing, data processing, and software operations in the health care industry.
• Knowledge of Urology technologies and surgical interventions.
• Comprehensive understanding of Medicare, Medicaid and commercial payer policy.
• Knowledge of medical coding including ICD-10 and CPT codes.
• Knowledge and experience with proposed and final CMS annual ruling.
• Demonstrates work experience applying PC-based analytic tools to provide support to a health insurance or clinical process (Excel, Word, etc.)
• Ability to travel up to 50%

Preferred qualifications:

• AAPC certification preferred
• Ability to successfully interact with all levels of management, both internal and external, third-party payers, and customers.
• Excellent communication and organizational skills.
• Comprehensive understanding of medical management and health insurance concepts, information systems and strong analytical and problem-solving skills.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.