Field Reimbursement Manager

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

📋 Description

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

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

• Train physician offices on payer systems and available services through remote engagements and in-person sessions.

• Cultivate relationships with healthcare providers and manufacturer representatives.

• Deliver on-site and on-demand educational sessions, including Lunch and Learn events and dinner presentations.

• Provide education on Benefit Investigations, Prior Authorizations, Support Center Services, as well as Medicare and Commercial coverage, and patient communication pathways.

• Offer reimbursement assistance for case management, updates on billing and coding, claims submissions, specialty pharmacy services, medical benefit interpretation, medical necessity evaluations, claims and appeals processes, copay assistance, and patient aid programs.

• Schedule appointments, conduct outbound calls to targeted offices, manage backlog casework, and perform daily office tasks.

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

• Maintain records of interactions and activities in the FRM CRM and hub systems, providing reports to management and clients.

• Assess territory and program performance through CRM dashboards, trend analysis, quarterly reports, and customer feedback surveys.

• Research and compile information on providers and manufacturer representatives, creating facility databases within the FRM CRM.

⛳️ Requirements

• Candidate must reside in the Portland, OR area.

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

• A minimum of 4 years of experience in healthcare-related reimbursement.

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

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

• Experience with Medicare and commercial insurance coverage.

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

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

• Capable of managing multiple priorities effectively with exceptional organizational skills.

• Strong computer proficiency, including experience with PowerPoint and web conferencing tools.

• Excellent interpersonal skills.

• Outstanding written and verbal communication skills.

• Strong problem-solving and decision-making abilities.

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

• A valid driver's license and a clean driving record/MVR are required.

🏝️ Benefits

• Competitive compensation package.

• Annual bonus opportunities may be available.

• Potential long-term incentive opportunities.

• Comprehensive Total Rewards benefits package.

• Remote work-from-home flexibility.