Reimbursement Coding & Strategy Director

Coding Strategy and Pathway Development

• Lead the development of U.S. coding strategies for pipeline, launch, and on-market diagnostic products.
• Assess available coding pathways, including CPT, PLA, HCPCS, and ICD-10 considerations, and recommend the pathway that best supports the intended use, site of service, and reimbursement objective.
• Identify coding gaps, risks, dependencies, and decision points early in product development and translate findings into actionable recommendations for governance and product teams.
• Develop long-range coding roadmaps, including key milestones, evidence needs, submission timing, ownership, and contingency approaches.
• Evaluate when existing codes may be appropriate and when a new or revised code may be needed, documenting the rationale, business impact, and implementation considerations.
• Adjust coding strategies for existing products in response to product changes, utilization patterns, coding updates, or reimbursement barriers.

Coding Applications, Evidence, and Documentation

• Lead or coordinate the preparation of coding applications, supporting narratives, technical documentation, and evidence packages in partnership with Government Affairs, Medical Affairs, Regulatory Affairs, HEOR, and other subject-matter experts.
• Define the clinical, technical, utilization, and economic evidence needed to support coding objectives and incorporate those requirements into evidence-generation plans.
• Ensure coding submissions and supporting materials accurately reflect product characteristics, intended use, clinical utility, and the applicable diagnostic pathway.
• Maintain a centralized record of coding decisions, assumptions, submission history, status, risks, and outcomes to support continuity and organizational learning.
• Coordinate internal review and approval of coding materials in accordance with company requirements and applicable standards.
• Represent and attend AMA, ADLM, ACLA, CAP, AMP.

Product Development and Launch Integration

• Represent Market Access and coding strategy in U.S. go-to-market, pipeline, and lifecycle governance processes.
• Integrate coding considerations into product profiles, evidence plans, launch sequencing, pricing and reimbursement planning, and commercial readiness activities.
• Provide U.S. coding insights to global teams and adapt global market access tools to address U.S. coding requirements.
• Partner with brand and commercial teams to develop coding-related launch plans, customer resources, internal training, and objection-handling tools.
• Assess the operational implications of coding decisions for laboratories, providers, revenue cycle teams, sales teams, and customer support functions.

Coding Intelligence, Governance, and Enablement

• Monitor coding publications, code-set updates, application cycles, and industry developments that may affect pipeline or on-market products.
• Analyze potential business and access impact, communicate findings to relevant stakeholders, and recommend response plans.
• Establish coding governance tools, decision frameworks, standard operating practices, and performance measures to improve consistency and execution.
• Develop and maintain approved coding guides, reimbursement resources, training materials, and internal reference tools.
• Serve as an internal expert and educator on diagnostic coding concepts, pathways, limitations, and appropriate use of coding information.
• Collect field and customer insights related to coding barriers and use those insights to refine product-level strategies and close access gaps.
• Perform all work in compliance with company quality procedures and standards.