Field Reimbursement Manager

📋 Description

• Address intricate patient access challenges by collaborating with the Hub, provider offices, and liaising with the client field team.

• Collaborate with the client’s Sales Team, Payer Teams, Marketing, Healthcare Professionals (HCPs), and their Specialty Pharmacies.

• Provide education to HCPs and Office Staff regarding Patient Support Programs.

• Assist healthcare providers in navigating the prior authorization and appeals process.

• The FRM will oversee daily operations that facilitate appropriate patient access to the client’s products.

• Work in conjunction with the client's patient support services program representatives on patient cases and claim-related issues.

• Perform policy monitoring across regional payers to guarantee correct coding, coverage, and payment for the client’s products.

• Conduct sales training focused on product reimbursement.

⛳️ Requirements

• An Associate's degree or higher in a relevant field or equivalent market experience.

• A minimum of 3 years in the Pharma/Healthcare industry, particularly with specialty products, Hubs, Payers, HCPs, or a related field.

• Required specific experience in practice management, billing, and/or coding for drugs, biologicals, or devices.

• Must possess a general understanding of payer policies, including those of public and private payers.

• Proven capability to provide virtual and field-based reimbursement support and education.

• Proficient in Prior Authorizations, reimbursement billing, coding, and the appeals process.

• Familiarity with commercial payer systems, as well as Medicare and Medicaid structures and reimbursement processes.

• Excellent stakeholder engagement and communication abilities.

🏝️ Benefits

• Access for patients to life-changing medications.

• Opportunities for innovation, advancement, and achievement.

• A diversity-driven organization that embraces an inclusive approach.