Role OverviewThe Field Reimbursement Manager is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives.
What You Will Do
Provide on-site and on-demand education for office staff in regard to Reimbursement challenges and support services. Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs.
Why It Might Be a Fit
Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis.
Requirements
- 4-year degree in related field or equivalent experience
- 4+ years of healthcare related reimbursement experience
- Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
- Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
- Must have Medicare and commercial insurance coverage experience
- Proven presentation skills and experience
- Proven ability to effectively handle multiple priorities and excellent organizational skills
- Strong Computer literacy to include PowerPoint and Web Meeting experience
- Previous field experience, a plus
- Previous experience with specialty pharmacy a plus
- Account management experience, a plus
- Excellent Interpersonal skills
- Excellent written and oral communication skills
- Problem solving and decision-making skills
Benefits
- Competitive compensation package
- Annual bonus or long-term incentive opportunities
- Base pay range: $84,300 - $140,500
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