Field Reimbursement Manager

This is a fully remote position, open to applicants in Maine, +2 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.

• Educate physician offices on payer landscapes and available services through remote engagements and in-person training.

• Cultivate relationships with physician offices and manufacturer representatives.

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

• Provide reimbursement education and support through both on-site and virtual interactions, averaging 15 sessions per week.

• Document activities in the FRM CRM on a daily basis and report to the manager on a weekly schedule.

• Offer education on Benefit Investigation, Prior Authorization, Support Center Services, Medicare and Commercial coverage, as well as patient communication streams.

• Supply 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.

• Collaborate with case managers and manage escalations effectively.

• Schedule appointments and conduct outbound calls to targeted offices.

• Assist with backlog casework and daily in-office tasks.

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

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

• Research and compile provider and manufacturer representative information for the reimbursement database.

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

⛳️ Requirements

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

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

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

• Preferred experience in supporting oncology products.

• Background in the healthcare sector, including insurance verification, prior authorizations, and/or claim adjudication, as well as within physician offices or clinics.

• Experience with Medicare and commercial insurance coverage.

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

• Proven skills in presentation and experience in public speaking.

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

• High level of computer literacy, including proficiency in PowerPoint and Web Meeting platforms.

• Previous field experience is advantageous.

• Experience in specialty pharmacy is a plus.

• Account management experience is beneficial.

• Exceptional interpersonal skills.

• Strong written and verbal communication abilities.

• Competence in problem-solving and decision-making.

• Must reside within the assigned territory.

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

• Must possess a valid driver's license with a clean driving record/MVR.

🏝️ Benefits

• Competitive compensation package.

• Potential annual bonus may be available.

• Opportunities for long-term incentives may be offered.

• Equity may be part of the compensation package.

• Commitment to equal employment opportunities.

• Reasonable accommodations for job searches or applications.