Field Reimbursement Manager

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

📋 Description

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

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

• Educate physician offices regarding payer landscapes and available services through both remote interactions and on-site training.

• Forge strong relationships with physician offices and manufacturer representatives.

• Collaborate with internal program hub support services to fulfill customer requirements.

• Coordinate site visits, manufacturer training sessions, and educational training venues via telephone.

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

• Conduct an average of 15 on-site or virtual office interactions each week and document activities in the FRM CRM system.

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

• Offer reimbursement support for case management, billing and coding updates, claims submissions, Specialty Pharmacy, Medical Benefit Interpretation, medical necessity, claims and appeals, co-pay assistance, and patient assistance programs.

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

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

• Track program and territory performance using FRM CRM dashboards and reports.

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

⛳️ Requirements

• Candidate must reside in the Grand Rapids or Flint, MI area.

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

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

• Strong experience in medical reimbursement, including Buy & Bill and/or Specialty Pharmacy.

• Background in the healthcare industry, including insurance verification, prior authorizations, and/or claim adjudication, 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.

• Capability to manage multiple priorities effectively along with excellent organizational skills.

• High level of computer proficiency, including PowerPoint and online meeting tools.

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

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

• Exceptional interpersonal, written, and verbal communication skills.

• Strong problem-solving and decision-making abilities.

🏝️ Benefits

• Competitive compensation package.

• Annual bonus potential.

• Opportunities for long-term incentives.

• Equity may be included as part of the compensation package.

• Flexible remote/work from home arrangement.