Serve as the primary field-facing contact for all access and reimbursement-related inquiries from assigned accounts.
Analyze and resolve reimbursement barriers, working cross-functionally with providers, internal revenue cycle teams, and payers when needed.
Track and report access challenges, trends, and opportunities in real-time.
Train provider staff on co-pay support, prior authorization processes, and coverage requirements to reduce delays and denials. Zio service billing and coding requirements
Documentation and medical necessity criteria
Prior authorization, claims appeals, and coverage trends
Integration of financial assistance programs into workflows
Strategic Market Access Engagement
Act as a regional subject matter expert on payer policy coverage, reimbursement pathways, acquisition models, and claims workflows.
Support pull-through of payer coverage policies, LCM decisions, and ensure alignment with commercial and market access strategy.
Identify evolving payer policies or state/federal regulation shifts and proactively communicate their impact to internal stakeholders.
Cross-Functional Collaboration
Partner with Sales (AVPs, RSDs, TMs), Revenue Cycle, Legal/Compliance, RCM and Patient Support to ensure seamless account engagement.
Collaborate with the Market Access team to build and execute regional access strategies.
Coordinate onboarding for new accounts with billing and service line integration support.
Compliance & Best Practices
Maintain deep knowledge of CMS policies (especially Medicare Parts B & D), commercial payer processes, and HIPAA compliance.
Act as an internal consultant on best practices to streamline access workflows and improve the provider/patient experience.
Reporting & Analytics
Use data to identify trends in denials, access delays, or payer barriers, and share insights to improve access pathways.
Identify opportunities for ConAl savings
Support market access dashboards and key performance metrics related to reimbursement and account performance.
Contribute insights from the field to enhance strategic decisions on coding, documentation, and patient affordability programs.
Qualifications & Skills
Required:
Bachelor's degree in healthcare administration, Life Sciences, Business, or related field preferred, commensurate experience may be considered.
5+ years in healthcare reimbursement, revenue cycle management, market access, or payer relations.
Strong understanding of coding (CPT/ICD-10), billing, coverage policies, and payer adjudication.
Experience interfacing with healthcare providers in a consultative, field-based role.
Proven ability to manage complex accounts, including IDNs, large health systems, and specialty practices.
Proficient in Microsoft Office Suite, CRM systems, and virtual communication platforms.
The ability to travel 50% or more based on territory needs.
Preferred:
CPC or relevant coding/billing certification.
Specialty pharmacy or diagnostics experience strongly preferred.
Prior experience with field-based roles in Market Access or Access & Reimbursement.
Knowledge of Medicare Advantage, Medicaid, and commercial payer landscape.
Strong business acumen and the ability to connect reimbursement strategy to commercial growth.
Core Competencies
Strategic problem-solving and root cause analysis
Ex
Benefits
Health insurance
Additional Information
Career-defining. Life-changing.
At iRhythm, you'll have the opportunity to grow your skills and your career while impacting the lives of people around the world. iRhythm is shaping a future where everyone, everywhere can access the best possible cardiac health solutions. Every day, we collaborate, create, and constantly reimagine what's possible. We think big and move fast, driven by our commitment to put patients first and improve lives. We need builders like you. Curious and innovative problem solvers looking for the chance to meaningfully shape the future of cardiac health, our company, and your career
About This Role:
Position Summary
The Reimbursement & Access Manager (RAM) is a commercially focused, field-based position responsible for ensuring patient access and reimbursement for iRhythm's Zio services across key accounts in their designated geography. This individual will act as a strategic partner to the field sales organization, healthcare providers, billing staff, and internal commercial stakeholders to proactively identify, educate, and resolve access barriers and reimbursement issues.
The RAM serves as the market-facing expert on payer policy, billing workflows, claims adjudication, and patient assistance programs. This role supports seamless integration of iRhythm services into clinical and operational pathways, driving both financial and clinical outcomes.
This position is ideal for a strategic, solutions-oriented individual who thrives in a fast-paced, mission-driven environment and is passionate about improving patient access through education, advocacy, and cross-functional collaboration.
Irhythmtech · Remote