Field Reimbursement Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Engage with key stakeholders in healthcare provider clinics, physician practices, or hospital outpatient settings.

• Serve as a bridge between healthcare provider offices and CareMetx program teams to facilitate complex reimbursement matters.

• Take charge of intricate or escalated reimbursement cases within the designated territory.

• Verify Prior Authorization and Appeal Requirements, and communicate necessary information to stakeholders.

• Monitor electronic payer billing codes for both pharmacy and medical payers.

• Create Appeal Packages for patient support programs; ensure stakeholders are updated on the status of Appeals when applicable.

• Support program teams in addressing escalated medical and pharmacy billing issues.

• Aid in resolving reimbursement challenges.

⛳️ Requirements

• Over 5 years of experience working with specialty healthcare providers in both pharmacy and medical billing, including buy and bill processes.

• Experience with Retinal services is strongly preferred.

• In-depth technical knowledge of healthcare reimbursement, encompassing coding, billing, the appeals process, and managing complex reimbursement issues with both patients and providers.

• An advanced degree or specific experience in Practice Management is preferred.

🏝️ Benefits

• Outstanding customer service provided to both internal and external clients.

• Flexible work arrangements available.

• Opportunities for professional development.