Field Reimbursement Manager

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

📋 Description

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

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

• Educate physician offices regarding payer landscapes and available services through both 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.

• Conduct approximately 15 on-site or virtual office interactions each week and record them in the FRM CRM system.

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

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

• Collaborate with case managers around four times monthly and address escalations as necessary.

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

• Interface with physicians and manufacturer representatives to exchange 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, creating facility databases in the FRM CRM.

• Travel and manage projects or coordinate accounts according to client expectations.

⛳️ Requirements

• Candidate must reside within the Louisville, KY area.

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

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

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

• Experience in healthcare settings, including insurance verification, prior authorizations, and/or claim adjudication, as well as in physician's offices or clinics.

• Familiarity with Medicare and commercial insurance coverage.

• Ability to deliver and document outcomes of benefit investigations and provide regular status reports.

• Demonstrated presentation skills and experience.

• Capable of managing multiple priorities with excellent organizational skills.

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

• Exceptional interpersonal skills.

• Excellent written and verbal communication abilities.

• Strong problem-solving and decision-making skills.

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

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

🏝️ Benefits

• Competitive compensation package.

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

• Comprehensive Total Rewards benefits package.

• Flexible remote, work-from-home arrangement.