Field Reimbursement Specialist

This is a fully remote position, open to applicants in Connecticut, +2 more states.

📋 Description

• Provide education to provider office staff and practice managers regarding the logistics necessary to support client products, including in-office administration infrastructure, buy and bill procedures, product monitoring, and updates on coverage and payer policies.

• Train provider office personnel on payer coverage management techniques, encompassing coding, billing, formulary issues, prior authorization, and appeal procedures.

• Investigate office processes to identify root causes of access or reimbursement challenges.

• Conduct engaging educational presentations at various provider service locations.

• Share information on pertinent reimbursement topics regarding client products, subject to client approval.

• Oversee daily operations that facilitate patient access to client products within provider offices.

• Serve as a liaison for patient assistance and reimbursement support services.

• Strategically plan and interact with customers utilizing client-sanctioned resources.

• Commit to weekly travel, occasionally requiring overnight stays, to healthcare facilities within the assigned territory.

• Execute additional responsibilities as required.

⛳️ Requirements

• Capable of delivering field-based reimbursement and access support, education, and consultation to key account clients and cross-functional teams.

• Familiarity with the distinctions between Specialty Pharmacy and Specialty Distribution.

• Comprehensive understanding of the physician buy-and-bill model compared to the assignment of benefits to alternative care sites.

• Background in revenue cycle management, buy and bill processes, including billing with miscellaneous J-codes, formulary management, benefit investigations, prior authorization, coding, and appeals.

• Profound knowledge of medical and pharmacy benefits and policies.

• High School Diploma or GED is mandatory.

• A Bachelor's degree or relevant Practice Management experience is preferred.

• Strong project management skills.

• Willingness and ability to travel extensively.

• Bilingual skills are desirable, though not mandatory.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Backup dependent care services.

• Assistance with adoption.

• Coverage for infertility treatments.

• Support for family building.

• Solutions for behavioral health.

• Paid parental leave.

• Paid caregiver leave.

• Opportunities for training programs.

• Resources for professional development.

• Mentorship initiatives.

• Employee resource groups.

• Opportunities for volunteer activities.