Field Reimbursement Manager

This is a fully remote position, open to applicants in Louisiana, +2 more states.

📋 Description

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

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

• Educate physician offices about payer dynamics and available services through remote engagement and in-person training.

• Cultivate relationships with healthcare providers and manufacturer representatives.

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

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

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

• Deliver reimbursement support for 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.

• Work collaboratively with case managers on about four interactions monthly and address escalations as necessary.

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

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

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

• Research and compile information on providers and manufacturer representatives, creating facility databases in FRM CRM.

⛳️ Requirements

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

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

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

• Background in the healthcare sector, encompassing insurance verification, prior authorizations, and/or claims adjudication, as well as experience in physician offices or clinics.

• Familiarity with Medicare and commercial insurance coverage.

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

• Demonstrated presentation skills and relevant experience.

• Ability to manage multiple priorities effectively and exhibit strong organizational skills.

• Proficient computer skills, including experience with PowerPoint and Web Meetings.

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

• Exceptional interpersonal, written, and verbal communication skills.

• Strong problem-solving and decision-making capabilities.

• Must reside within the designated territory.

• Willingness to travel 80% of the time by car or plane.

• Possession of a valid driver’s license with a clean driving record/MVR.

🏝️ Benefits

• Competitive compensation package.

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

• Flexible remote, work-from-home arrangement.

• Equal employment opportunities provided.

• Reasonable accommodations available for applicants with disabilities.