I have a .cer file output from a successful LetsEncrypt certificate request.
I have the original Private Key used to create the Certificate Signing Request (CSR) for
CryptoGuy's answer was really helpful and pointed us in the right direction.
We were still struggling to import a Binary DER file but this code fixed that:
var oc = OpenSSL.X509.X509Certificate.FromDER(bio);
These pages were useful:
https://github.com/openssl-net/openssl-net/blob/master/ManagedOpenSsl/X509/X509Certificate.cs
https://msdn.microsoft.com/en-us/library/system.security.cryptography.x509certificates.x509certificate2.rawdata
Thanks all for your help :)