Field Reimbursement Manager

This is a fully remote position, open to applicants in Arizona, +7 more states.

📋 Description

• Oversee a designated territory to provide reimbursement and patient services for a specific medication.

• Provide assistance with Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals processes.

• Educate physician offices about payer landscapes and available services through remote interactions and on-site training sessions.

• Develop and maintain relationships with physician offices and manufacturer representatives.

• Work in conjunction with internal program hub support services to address customer needs.

• Schedule site visits, manufacturer training sessions, and educational training events via telephone.

• Offer on-site and on-demand education, including Lunch and Learns or dinner presentations.

• Conduct approximately 15 on-site or virtual office interactions weekly and document activities in the FRM CRM.

• Provide education on Benefit Investigation, Prior Authorization, Support Center Services, Medicare and Commercial coverage, and patient communication channels.

• Deliver reimbursement support for case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, co-pay assistance, and patient assistance programs.

• Set appointments, make outbound calls to targeted offices, assist with backlog casework, and perform daily in-office tasks.

• Collaborate with physicians and manufacturer representatives to share patient and provider-specific information.

• Monitor program performance and communicate trends to management and clients.

• Research and gather information about providers and manufacturer representatives for reimbursement databases.

• Create facility databases for new providers within the FRM CRM.

⛳️ Requirements

• Bachelor's degree in a related field or equivalent experience.

• Over 4 years of experience in healthcare-related reimbursement.

• Strong experience in medical reimbursement, particularly with Buy & Bill and/or Specialty Pharmacy.

• Background in the healthcare industry, including insurance verification, prior authorizations, and/or claim adjudication, as well as experience in physician offices or clinics.

• Familiarity with Medicare and commercial insurance coverage.

• Ability to communicate and document benefit investigation outcomes and provide regular status reports.

• Proven presentation skills and relevant experience.

• Capable of managing multiple priorities with excellent organizational skills.

• Strong computer skills, including proficiency in PowerPoint and Web Meeting platforms.

• Previous field experience, specialty pharmacy experience, and account management experience are advantageous.

• Excellent interpersonal, written, and verbal communication abilities.

• Strong problem-solving and decision-making capabilities.

• Must reside within the designated territory.

• Willingness to travel 20% via automobile or airplane.

• Possession of a valid driver's license with a clean driving record/MVR.

🏝️ Benefits

• Competitive compensation package.

• Opportunities for annual bonuses or long-term incentives may be available.

• Commitment to equal employment opportunities.

• Reasonable accommodations provided for applicants with disabilities.