Field Reimbursement Manager

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

📋 Description

• Oversee a designated territory to provide 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 payer landscapes and available services through both remote communication and on-site training sessions.

• Foster relationships with physician offices and representatives from manufacturers.

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

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

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

• Conduct around 15 on-site or virtual office interactions each week.

• Log daily activities in FRM CRM and provide weekly reports to management.

• Educate on benefit investigation, prior authorizations, Support Center Services, Medicare and commercial coverage, and patient communication channels.

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

• Collaborate with case managers on roughly four cases per month and address escalations as necessary.

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

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

• Track program and territory performance using FRM CRM dashboards and quarterly reporting.

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

• Develop facility databases for new providers within FRM CRM.

⛳️ Requirements

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

• Minimum of 4 years of experience in healthcare-related reimbursement.

• Extensive medical reimbursement expertise, particularly with Buy & Bill and/or Specialty Pharmacy.

• Experience in supporting GLP-1 and Cardiology products.

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

• Familiarity with Medicare and commercial insurance coverage.

• Capability to present and document benefit investigation outcomes while providing regular status updates.

• Effective presentation skills and relevant experience.

• Ability to manage multiple priorities with strong organizational skills.

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

• Exceptional interpersonal, written, and verbal communication abilities.

• Strong problem-solving and decision-making capabilities.

• Must reside within the designated territory.

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

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

🏝️ Benefits

• Competitive compensation package.

• Opportunities for annual bonuses.

• Long-term incentive opportunities.

• Equity may be part of the compensation package.

• Flexible remote work-from-home arrangement.

• Equal employment opportunities are provided.

• Reasonable accommodations available for job search or application.