Field Reimbursement Manager

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

📋 Description

• Oversee a designated territory concentrating on reimbursement and patient services pertaining to a specific medication.

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

• Inform physician offices regarding payer landscapes and available services through remote engagement and on-site training.

• Develop and maintain relationships with physician offices and manufacturer representatives.

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

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

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

• Conduct around 15 on-site/virtual office interactions weekly and document activities in FRM CRM.

• Provide education on benefit investigation, prior authorization, support center services, Medicare and commercial coverage, and patient communication pathways.

• Offer reimbursement assistance that includes 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 and make outbound calls to targeted offices.

• Aid with backlog casework and daily in-office tasks.

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

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

• Research and compile information on providers/manufacturer representatives and create facility databases in FRM CRM.

⛳️ Requirements

• Applicants must reside in the Nashville, TN 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 in the healthcare sector, including insurance verification, prior authorizations, and/or claim adjudication, as well as working in physician’s offices or clinics.

• Familiarity with Medicare and commercial insurance coverage.

• Capability to deliver and document benefit investigation results and provide status reports consistently.

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

• Ability to manage multiple priorities efficiently with excellent organizational skills.

• Proficient in computer applications, including PowerPoint and Web Meeting platforms.

• Exceptional interpersonal skills.

• Strong written and verbal communication abilities.

• Effective problem-solving and decision-making skills.

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

• Equity may be included as part of the compensation package.

• Reasonable accommodations for applicants with disabilities.