Field Reimbursement Manager

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

📋 Description

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

• Provide assistance with Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals processes.

• Educate healthcare providers about payer landscapes and available services through both remote engagement and on-site training sessions.

• Cultivate relationships with physician practices and manufacturer representatives.

• Communicate via telephone with healthcare providers and internal teams to organize site visits, manufacturer training, and educational events.

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

• Conduct an average of 15 on-site or virtual office interactions weekly and maintain documentation of these activities in FRM CRM.

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

• Offer reimbursement support for case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, copay assistance, and patient assistance programs.

• Collaborate with case managers on approximately four interactions monthly and address escalations as necessary.

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

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

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

• Research and compile information on providers/manufacturer representatives and create facility databases within FRM CRM.

• Travel extensively and manage projects/accounts according to client expectations.

⛳️ Requirements

• Candidates must reside within the Las Vegas, NV area.

• Bachelor’s degree in a relevant field or equivalent experience is required.

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

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

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

• Knowledge of Medicare and commercial insurance coverage is essential.

• Ability to convey and document benefit investigation results, along with providing regular status updates.

• Proven skills in delivering presentations and experience in this area.

• Capacity to manage multiple priorities effectively, demonstrating excellent organizational skills.

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

• Strong interpersonal abilities.

• Exceptional written and verbal communication skills.

• Strong problem-solving and decision-making capabilities.

• Must live within the designated territory: Las Vegas, NV.

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

• A valid driver's license with a clean driving record/MVR is required.

• The role may involve prolonged periods of sitting and/or keyboard work along with general office demands.

🏝️ Benefits

• Competitive compensation package.

• An annual bonus may be available.

• Long-term incentive opportunities may be offered.

• Benefits information can be accessed through McKesson Total Rewards.