Reimbursement & Revenue Cycle Manager

Job Title: Reimbursement & Revenue Cycle Manager – Spine TechnologiesPosition SummaryThe Reimbursement & Revenue Cycle Manager supports market adoption of a novel spine surgery technology by providing reimbursement, billing, and coding expertise to hospitals, ASCs, and surgeons. This role serves as a subject matter expert on facility and professional claims, helping customers navigate coverage, coding, and payment pathways across Medicare and commercial payers.Key ResponsibilitiesServe as a reimbursement and revenue cycle subject matter expert for a spine surgery medical device portfolioProvide billing, coding, and claims guidance to hospitals, ASCs, and physician practices for both facility and professional servicesSupport correct use of ICD-10-CM/PCS, CPT, and HCPCS codes associated with spine procedures and implantable devicesAdvise customers on inpatient and outpatient reimbursement methodologies including MS-DRGs, APCs, ASC payment systems, and Physician Fee ScheduleAssist with claim submission strategy, including device reporting, modifiers, C-codes (when applicable), and documentation requirementsSupport denial prevention and resolution efforts by analyzing payer denials, EOBs, and remittance adviceProvide guidance on prior authorization, coverage policies, and medical necessity documentationPartner with sales, clinical, and marketing teams to support customer education and adoptionDevelop reimbursement tools and resources such as coding guides, billing checklists, FAQs, and payer education materialsMonitor changes in CMS rules, coding updates, and payer policies impacting spine surgery reimbursementSupport reimbursement-related customer inquiries, escalations, and training initiativesRequired Qualifications3–7 years of experience in healthcare revenue cycle, reimbursement, billing, or codingDirect experience with hospital/facility billing or physician professional billingStrong working knowledge of ICD-10-CM/PCS, CPT, and HCPCS codingUnderstanding of Medicare and commercial payer reimbursement models, including MS-DRGs, APCs, ASC payment, and PFSExperience interpreting payer coverage policies, LCDs/NCDs, and medical necessity criteriaAbility to translate complex reimbursement concepts into clear guidance for customersPreferred QualificationsFamiliarity with spine, orthopedics, or neurosurgery procedures and common reimbursement pathwaysExperience supporting new or emerging technologies, Category III CPT codes, or NTAP/TPT pathwaysProfessional certification such as CPC, CCS, RHIA, RHIT, or CPBExperience with claims appeals, peer-to-peer reviews, or payer educationSkills & CompetenciesStrong analytical and problem-solving skillsExcellent written and verbal communication skillsCustomer-facing mindset with the ability to educate and influenceAbility to work cross-functionally with sales, clinical, regulatory, and marketing teamsDetail-oriented with strong compliance and ethics focusComfortable operating in an evolving reimbursement landscape