Field Reimbursement Manager

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

📋 Description

• Oversee a designated territory with a focus on reimbursement and patient services.

• Assist with challenges related to patient reimbursement, including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals.

• Provide education to physician offices regarding the payer landscape and available services through remote interactions and on-site training sessions.

• Cultivate relationships with physician offices and representatives from manufacturers.

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

• Conduct an average of 15 on-site and virtual interactions each week.

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

• Offer education regarding Benefit Investigation, the Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and communication strategies for patients.

• Provide reimbursement assistance that encompasses case management, billing and coding updates, claims submission, Specialty Pharmacy, Medical Benefit Interpretation, medical necessity, claims and appeal support, co-pay assistance, and patient assistance programs.

• Collaborate with case managers approximately four times a month and as needed for escalations.

• Schedule appointments and make outbound calls to targeted offices.

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

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

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

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

• Develop facility databases for new providers within the FRM CRM.

• Travel, manage projects, and/or coordinate accounts in alignment with client expectations.

⛳️ Requirements

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

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

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

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

• Familiarity with Medicare and commercial insurance coverage.

• Capability to deliver and document outcomes of benefit investigations and provide regular status reports.

• Proven skills in presenting information effectively.

• Ability to manage multiple priorities with excellent organizational capabilities.

• Strong computer skills, including proficiency in PowerPoint and experience with Web Meetings.

• Exceptional interpersonal skills.

• Outstanding written and verbal communication skills.

• Effective problem-solving and decision-making abilities.

• Must live within the designated territory.

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

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

🏝️ Benefits

• Competitive compensation package.

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

• Benefits information can be accessed through McKesson's Total Rewards program.