Field Reimbursement Manager

This is a fully remote position, open to applicants in Maryland, +1 more state.

📋 Description

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

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

• Provide education to physician offices regarding the payer landscape and available services through both remote engagement and in-person training.

• Cultivate relationships with physician offices and manufacturer representatives.

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

• Facilitate reimbursement education and support via on-site and virtual interactions, averaging 15 engagements per week.

• Educate on Benefit Investigation, Prior Authorization, Support Center Services, Medicare and commercial coverage, as well as patient communication channels.

• Deliver reimbursement assistance 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.

• Collaborate with case managers approximately four times a month and address escalations as necessary.

• Schedule appointments and perform outbound calls to targeted offices.

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

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

• Maintain records of interactions and activities within FRM CRM and hub systems.

• Assess program and territory performance through CRM dashboards, reporting, trending, and customer surveys.

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

• Establish facility databases for new providers in FRM CRM.

• Travel extensively within the assigned territory.

⛳️ Requirements

• Bachelor's degree in a related 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.

• Experience in the healthcare sector, encompassing insurance verification, prior authorizations, and/or claim adjudication, within physicians’ offices or clinics.

• Familiarity with Medicare and commercial insurance coverage.

• Ability to convey and document outcomes of benefit investigations and provide regular status updates.

• Demonstrated presentation skills and relevant experience.

• Capacity to effectively manage multiple priorities and possess excellent organizational abilities.

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

• Valid driver's license with a clean driving record/MVR.

• Residency within the designated territory is required.

• Willingness to travel up to 80% (4 days a week) by car or plane.

• Exceptional interpersonal skills.

• Outstanding written and verbal communication abilities.

• Strong problem-solving and decision-making capabilities.

🏝️ Benefits

• Attractive compensation package.

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

• Equity may be part of the total rewards package.

• Commitment to equal employment opportunities.

• Reasonable accommodations available for applicants with disabilities.