Field Reimbursement Manager

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

📋 Description

• Oversee a designated territory, providing support for reimbursement and patient services related to a specific medication.

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

• Inform physician offices about the payer landscape and available services through both remote interactions and on-site training sessions.

• Establish and nurture relationships with physician offices and manufacturer representatives.

• Work in collaboration with internal program hub support services to fulfill customer requirements.

• Communicate via telephone with providers and internal personnel to schedule site visits, manufacturer training, and educational training events.

• Deliver both on-site and on-demand education, which may include Lunch and Learns or Dinner presentations.

• Conduct approximately 15 on-site or virtual office interactions weekly and document activities daily in the FRM CRM, with weekly reports to management.

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

• Submit monthly reports on educational activities and analyze trends quarterly for clients.

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

• Collaborate with case managers on an average of 4 cases each month and address escalations as necessary.

• Schedule appointments and make outbound calls to targeted offices.

• Assist with backlog casework and additional daily in-office responsibilities.

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

• Monitor program and territory performance using the FRM CRM dashboard and through quarterly reports.

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

• Develop a facility database for each new provider in the FRM CRM.

⛳️ Requirements

• Candidates must reside within the Minneapolis, MN area.

• A 4-year degree in a related field or equivalent experience is required.

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

• Strong experience with medical reimbursement associated with Buy & Bill and/or Specialty Pharmacy is required.

• Experience in the healthcare sector, including insurance verification, prior authorizations, and/or claims adjudication within physician’s offices or clinics.

• Must have experience with Medicare and commercial insurance coverage.

• Capable of delivering and documenting benefit investigation results and providing status updates regularly.

• Proven skills in presentation and experience in delivering effective presentations.

• Demonstrated ability to manage multiple priorities and possess excellent organizational skills.

• Strong computer skills, including proficiency in PowerPoint and Web Meeting platforms.

• Must reside in the Minneapolis, MN territory.

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

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

• Ability to manage long periods of sitting and/or keyboard work; general office demands are expected.

🏝️ Benefits

• Competitive compensation package.

• Annual bonus opportunities may be available.

• Long-term incentive opportunities may be provided.

• Comprehensive Total Rewards benefits package.