Field Reimbursement Manager

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

📋 Description

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

• Assist with Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals.

• Educate physician offices on the payer landscape and available services through both remote communication and on-site training.

• Foster relationships with physician offices and manufacturer representatives.

• Collaborate with internal program hub support services to address customer needs.

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

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

• Offer reimbursement assistance concerning 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.

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

• Exchange patient- and provider-specific information with physicians and manufacturer representatives.

• Monitor territory and program performance utilizing FRM CRM dashboards and reporting tools.

• Research and gather information on providers and manufacturer representatives, creating facility databases in FRM CRM.

• Log interactions and activities in FRM CRM; provide daily, weekly, monthly, and quarterly reports.

⛳️ Requirements

• Candidate must reside in the Raleigh, NC area.

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

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

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

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

• Must have experience with Medicare and commercial insurance coverage.

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

• Proven presentation skills and experience.

• Demonstrated ability to effectively manage multiple priorities along with excellent organizational skills.

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

• Must live within the designated territory – Raleigh, NC.

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

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

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

• Exceptional interpersonal, written, and oral communication abilities.

• Strong problem-solving and decision-making capabilities.

🏝️ Benefits

• Competitive compensation package.

• Potential for an annual bonus.

• Long-term incentive opportunities may be available.

• Comprehensive Total Rewards package.

• Flexible remote, work-from-home arrangement.