Patient Access Manager (remote – N/A, US, 65401)

About Heraeus

Solutions from the Heraeus Group provide faster internet, rid water of germs, and keep hearts beating in time. As a broadly diversified and globally leading family-owned technology company, we combine materials expertise and technological leadership to create the most diverse products, all with one thing in common: World-class quality. Working with customers around the world, we shape the future and provide vital innovations in the areas of Metals & Recycling, Healthcare, Semiconductor & Electronics and Industrials. Heraeus is one of the top 10 family-owned companies in Germany and has a team of around 17,200 employees in 40 countries.

 

About Engineered Tissue Solutions

Engineered Tissue Solutions was acquired in 2021 by the Heraeus Group, a broadly diversified family-owned technology company. Learn more about Heraeus Group at www.heraeus.com.

 

The following challenges await you:

Program Development & Leadership

• Design and implement the patient access program strategy, including workflows, standard operating procedures, and key performance metrics
• Advise on case management systems and technology tools to support efficient operations and reporting
• Develop training materials and knowledge resources covering wound care coding, payer policies, and appeals strategies
• Create dashboards and reporting frameworks to track program performance, identify trends, and inform continuous improvement
• Partner with sales, marketing, and medical affairs to align patient access support with commercial objectives
• Collaborate with sales, patient services vendors, and provider office staff to streamline workflows, resolve access issues quickly, and support a frictionless Mirragen treatment journey
• Feed real-world insights (e.g., common denial reasons, documentation gaps, coding challenges, payer policy trends) to commercial, market access, and medical affairs teams to refine strategy, evidence generation, and provider tools
• Hire/train additional staff as volume grows

 

Hands-On Case Management

• Manage a personal caseload of patients requiring reimbursement support
• Conduct benefit investigations and verify patient coverage across the full spectrum of health plans
• Complete and submit prior authorization requests with appropriate clinical documentation and coding
• Draft and submit appeals for denied authorizations and claims
• Document all case activities in the case management platform with accuracy and attention to compliance requirements
• Champion an exceptional patient and HCP experience by ensuring that all communications and case updates are clear, empathetic, timely, and tailored to the needs of patients, caregivers, and providers

 

Compliance & Quality

• • Ensure all patient access activities comply with HIPAA, state privacy laws, and company policies
  • Maintain accurate and auditable records for all patient interactions and case outcomes
  • Stay current on wound care reimbursement policy changes, LCD/NCD updates, and coding revisions
  • Support internal and external audits as needed.

 

Your Profile:

• Minimum 5 years of experience in patient access, reimbursement support, or medical billing/coding
• Direct experience with wound care, vascular, or related therapeutic areas (e.g., advanced wound dressings, negative pressure wound therapy, compression therapy, skin substitutes, peripheral vascular devices)
• Demonstrated expertise in prior authorizations, appeals, and benefit investigations
• Strong working knowledge of Medicare, Medicaid, and commercial payer policies and processes
• Experience with medical coding systems (CPT, HCPCS, ICD-10-CM) relevant to wound care and vascular procedures
• Excellent written and verbal communication skills
• Associate's degree required; Bachelor's degree preferred

     

 Preferred Qualifications

• • Experience building or scaling a patient access program or reimbursement team
  • Prior supervisory or team leadership experience
  • Experience with case management platforms (e.g., Salesforce Health Cloud, custom CRM systems)
  • Background in medical device or pharmaceutical manufacturer patient services