Field Reimbursement Manager

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

📋 Description

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

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

• Educate physician offices about payer environments and available services through remote interactions and in-person training.

• Foster relationships with physician offices and manufacturer representatives.

• Work collaboratively with internal program hub support services to fulfill customer needs.

• Organize site visits, manufacturer training sessions, and educational training locations via telephone.

• Offer on-site and on-demand education, such as Lunch and Learn sessions or Dinner presentations.

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

• Document activities in the FRM CRM daily and provide weekly reports to the manager.

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

• Deliver 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 approximately four times monthly and as required for escalations.

• Schedule appointments and make outbound calls to targeted offices.

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

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

• Track program and territory performance utilizing FRM CRM dashboards and quarterly reports.

• Research and compile information about providers/manufacturer representatives for reimbursement databases and create facility databases for new providers.

⛳️ Requirements

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

• At least 4 years of experience in healthcare-related reimbursement.

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

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

• Familiarity with Medicare and commercial insurance coverage.

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

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

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

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

• Exceptional interpersonal abilities.

• Excellent written and verbal communication skills.

• Strong problem-solving and decision-making capabilities.

• Must reside within the designated territory.

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

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

🏝️ Benefits

• Competitive salary and compensation package.

• Opportunities for annual bonuses or long-term incentives may be available.

• Flexible remote, work-from-home setup.

• Equal employment opportunities for all candidates.

• Reasonable accommodations for applicants with disabilities.