Director, Insurance & Reimbursement

The Director, Insurance & Reimbursement is responsible for providing strategic leadership and operational oversight for Oticon Medical's U.S. Insurance & Reimbursement organization. This position is accountable for developing and executing reimbursement strategies that maximize patient access, improve revenue realization, strengthen payer relationships, and deliver an exceptional customer experience.

The Director leads all aspects of reimbursement operations, including insurance verification, prior authorizations, credentialing, claims management, appeals, collections support, payer contracting, and reimbursement policy. Working cross-functionally with Sales, Customer Service, Finance, Clinical, Marketing, Regulatory Affairs, External Parties/Consultant Relationships, and Executive Leadership, this individual develops scalable processes that improve operational efficiency while supporting the company's commercial objectives.

The Director is expected to build and lead a high-performing organization that combines operational excellence with strategic thinking, ensuring Oticon Medical remains a trusted partner for providers, patients, and payers.

• Develop and execute the Company's U.S. Insurance & Reimbursement strategy.
• Establish departmental goals, key performance indicators (KPIs), and operational metrics.
• Build an organization capable of supporting future business growth and product expansion.
• Extensive management of external parties/consultant relationships, including credentialing and billing.
• Develop annual operating plans and departmental budgets.
• Provide strategic recommendations to executive leadership regarding reimbursement opportunities and risks.
• Foster a culture of accountability, continuous improvement, collaboration, and customer focus.

• Direct all insurance verification, benefits investigations, prior authorizations, claims submission, appeals, and reimbursement activities.
• Oversee denial management processes and implement strategies that improve approval rates and reimbursement outcomes.
• Establish service level expectations and performance standards for all reimbursement functions.
• Monitor reimbursement performance through key operational metrics and implement corrective actions when necessary.
• Ensure timely and accurate processing of all reimbursement-related activities.
• Drive improvements that reduce reimbursement cycle times and increase collection performance.

• Lead Medicare, Medicaid, VA, and commercial payer credentialing initiatives.
• Develop strategies to expand payer participation and improve patient access. Provide clear and strategic guidance and prioritization to external parties/consultants.
• Provide clear and strategic guidance and prioritization to external parties/consultants.
• Maintain relationships with commercial insurers, government agencies, and third-party administrators.
• Monitor changes in reimbursement policies, coverage determinations, and healthcare regulations.
• Evaluate reimbursement implications associated with new products and market opportunities.

• Partner with Finance to improve reimbursement collections and reduce outstanding insurance receivables.
• Monitor reimbursement trends and identify opportunities to improve financial performance.
• Develop reporting tools that provide visibility into reimbursement performance, denials, appeals, collections, and payer activity.
• Recommend operational improvements that positively impact revenue realization.

• Partner with Sales to remove reimbursement barriers affecting customer adoption.
• Collaborate with Customer Service to deliver a seamless customer experience.
• Support Marketing with reimbursement messaging, educational materials, and product launches.
• Work closely with Clinical, Regulatory Affairs, and Quality to ensure reimbursement strategies align with regulatory requirements and clinical evidence.
• Support Executive Leadership with reimbursement analysis and strategic planning.

• Develop, implement, and maintain departmental policies, procedures, and quality standards.
• Identify opportunities to improve workflow efficiency through automation and technology.
• Ensure compliance with all federal, state, payer, and company policies.
• Maintain appropriate documentation, audit readiness, and quality assurance processes.
• Promote continuous improvement initiatives across the…