Field Reimbursement Manager

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

📋 Description

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

• Support Benefit Investigations, Prior Authorizations, Claims Assistance, and Appeals processes.

• Educate physician offices regarding the payer landscape and available services through remote engagements and on-site training sessions.

• Cultivate relationships with physician offices and representatives from the manufacturer.

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

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

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

• Provide reimbursement education and assistance through approximately 15 on-site/virtual interactions each week.

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

• Educate on Benefit Investigations, Prior Authorizations, Support Center Services, Medicare and Commercial coverage, and communication streams for patients.

• Offer reimbursement assistance 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 on roughly four cases monthly and manage escalations as necessary.

• Schedule appointments, perform outbound calls to targeted offices, and assist with backlog casework.

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

• Monitor the performance of physician and manufacturer representative programs using FRM CRM dashboards and quarterly reports.

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

⛳️ Requirements

• Candidate must reside in the Long Island, NY area.

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

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

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

• Experience supporting oncology products is preferred.

• Familiarity with the healthcare industry, including insurance verification, prior authorizations, and/or claim adjudication, as well as experience in physician offices or clinics.

• Must have experience with Medicare and commercial insurance coverage.

• Ability to deliver and document benefit investigation results and provide status reports regularly.

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

• Capable of managing multiple priorities with excellent organizational skills.

• Strong proficiency in computer applications, including PowerPoint and web meeting tools.

• Previous field experience, specialty pharmacy experience, and account management experience are advantageous.

• Excellent interpersonal capabilities.

• Outstanding written and verbal communication skills.

• Strong problem-solving and decision-making abilities.

• Must reside in the Long Island, NY territory.

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

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

🏝️ Benefits

• Competitive compensation package.

• Annual bonus may be available.

• Opportunities for long-term incentives may be offered.

• Equal employment opportunities.

• Reasonable accommodations for job search or application processes.