Field Reimbursement Manager

This is a fully remote position, open to applicants in District of Columbia, +4 more states.

📋 Description

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

• Assist 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.

• Cultivate relationships with physician offices and manufacturer representatives.

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

• Offer reimbursement support related to 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.

• Conduct approximately 15 on-site/virtual office interactions weekly and maintain documentation of activities in FRM CRM.

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

• Collaborate with case managers on roughly four cases monthly and address escalations as necessary.

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

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

• Track territory and program performance using FRM CRM dashboards and quarterly reports.

• Research and compile information on providers/manufacturer representatives and create facility databases in FRM CRM.

• Travel for client-driven project management and account coordination purposes.

⛳️ Requirements

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

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

• Strong expertise in medical reimbursement with Buy & Bill and/or Specialty Pharmacy.

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

• Familiarity with Medicare and commercial insurance coverage.

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

• Proven skills in presenting and experience in public speaking.

• Ability to manage multiple priorities effectively along with excellent organizational skills.

• Strong computer skills, including proficiency in PowerPoint and web meeting platforms.

• Previous field experience is advantageous.

• Prior experience in specialty pharmacy is a plus.

• Experience in account management is a plus.

• Excellent interpersonal, written, and verbal communication skills.

• Strong problem-solving and decision-making abilities.

• Must reside in the designated territory.

• Willingness to travel 80% of the time (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.

• Potential for annual bonuses or long-term incentive opportunities.

• Equity may be included as part of the total rewards package.

• Flexible remote, work-from-home arrangement.

• Commitment to equal employment opportunities.

• Reasonable accommodations for applicants with disabilities.