Field Reimbursement Manager

This is a fully remote position, open to applicants in Connecticut, +3 more states.

📋 Description

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

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

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

• Foster relationships with physician offices and representatives from manufacturing companies.

• Collaborate with internal support services to address customer requirements effectively.

• Organize site visits, training sessions with manufacturers, and educational training locations via telephone.

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

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

• Provide education on benefit investigation, prior authorization, support center services, Medicare and commercial coverage, and patient communication channels.

• Offer reimbursement support for case management, updates on billing and coding, claims submissions, specialty pharmacy services, medical benefit interpretation, medical necessity determinations, claims and appeals processes, copay assistance, and patient assistance programs.

• Schedule appointments, perform outbound calls to targeted offices, assist with backlog casework, and carry out daily office tasks.

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

• Monitor program and territory performance using CRM dashboards and quarterly reports.

• Research and compile information on providers and manufacturer representatives to create facility databases within the FRM CRM system.

• Travel approximately 80% of the time by automobile or plane.

⛳️ Requirements

• A Bachelor’s degree in a related field or equivalent work experience.

• A minimum of 4 years of experience in healthcare-related reimbursement.

• Extensive medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy practices.

• Experience in the healthcare industry, including insurance verification, prior authorizations, and claim adjudication.

• Experience working in a physician’s office or clinic setting.

• Familiarity with Medicare and commercial insurance coverage.

• Ability to communicate and document outcomes of benefit investigations and provide regular status updates.

• Proven skills in delivering presentations and experience in public speaking.

• Capability to manage multiple priorities while demonstrating excellent organizational skills.

• Proficiency in computer applications, including PowerPoint and online meeting platforms.

• Strong interpersonal skills.

• Exceptional written and verbal communication skills.

• Adept problem-solving and decision-making abilities.

• Must reside within the designated territory.

• Willingness to travel 80% of the time (approximately 4 days a week) by automobile or plane.

• Must possess 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.

• Equity might be included as part of the overall rewards.

• Flexible remote, work-from-home arrangement.

• Equal employment opportunities for all candidates.

• Reasonable accommodations provided for applicants with disabilities.