Field Reimbursement Manager

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

📋 Description

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

• Assist with Benefit Investigations, Prior Authorizations, Claims Assistance, and Appeals processes.

• Educate physician offices regarding payer landscapes and available services through virtual interactions and in-person training sessions.

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

• Conduct approximately 15 office interactions per week, either on-site or virtually, while documenting these in the FRM CRM.

• Inform offices about Benefit Investigations, prior authorizations, Support Center Services, Medicare and commercial insurance coverage, and patient communication methodologies.

• Offer reimbursement support concerning case management, billing and coding, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, and assistance programs.

• Collaborate with case managers about four times per month and as required for escalations.

• Schedule appointments, make outbound calls to targeted offices, and assist with backlog casework.

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

• Monitor program and territory performance utilizing FRM CRM dashboards and quarterly reports.

• Research and compile information on providers and manufacturer representatives for reimbursement databases.

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

⛳️ Requirements

• Candidate must reside within the Chicago, IL area.

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

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

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

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

• Familiarity with Medicare and commercial insurance coverage is essential.

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

• Proven skills in presentation and experience in delivering effective presentations.

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

• Strong computer skills, including proficiency in PowerPoint and experience with web meetings.

• 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 required.

• Exceptional interpersonal, written, and verbal communication skills.

• Strong problem-solving and decision-making abilities.

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

🏝️ Benefits

• Competitive compensation package.

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

• Flexible remote work-from-home arrangement.

• Global Equal Opportunity Employer.

• Reasonable accommodations available for job seekers with disabilities.