Field Reimbursement Manager

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

📋 Description

• Oversee a designated territory, providing support for reimbursement and patient services related to a particular medication.

• Assist patients with Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals processes.

• Inform physician offices about payer landscapes and available services through remote interactions and in-person training sessions.

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

• Deliver on-site and on-demand educational presentations, including Lunch and Learns and Dinner sessions.

• Educate offices on Benefit Investigation, Prior Authorization, Support Center Services, Medicare and Commercial coverage, and patient communication methods.

• Offer reimbursement support regarding 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.

• Collaborate with case managers on escalated issues.

• Schedule appointments and conduct outbound calls to targeted offices.

• Assist with backlog casework and additional daily in-office tasks.

• Interact with physicians and manufacturer representatives to gather and provide patient- and provider-specific information.

• Document all interactions and activities in the FRM CRM and hub system.

• Monitor program and territory performance through CRM dashboards and reporting tools.

• Research and compile information about providers and manufacturer representatives for the reimbursement database.

• Establish facility databases for new providers in the FRM CRM.

⛳️ Requirements

• Candidates must reside within the Los Angeles, CA area.

• A 4-year degree in a relevant field or equivalent experience is required.

• At least 4 years of experience in healthcare-related reimbursement is essential.

• Strong background in medical reimbursement with Buy & Bill and/or Specialty Pharmacy is preferred.

• Experience in the healthcare industry, including insurance verification, prior authorizations, and/or claim adjudication within physician offices or clinics.

• Familiarity with Medicare and commercial insurance coverage is necessary.

• Capability to deliver and document benefit investigation outcomes and provide regular status updates.

• Demonstrated presentation skills and experience.

• Ability to manage multiple priorities effectively.

• Exceptional organizational skills are required.

• Strong computer proficiency, especially with PowerPoint and web meeting tools.

• Excellent interpersonal skills are essential.

• Outstanding written and verbal communication skills are required.

• Strong problem-solving and decision-making abilities.

• Must be willing to travel 80% of the time (4 days a week) by car or plane.

• A valid driver's license with a clean driving record/MVR is mandatory.

🏝️ Benefits

• Competitive compensation package.

• Annual bonuses or long-term incentive opportunities may be available.

• Remote, work-from-home arrangement.

• Opportunities for professional growth and development.

• Equal employment opportunities.

• Reasonable accommodations for job search or application processes.