Field Reimbursement Specialist

This is a fully remote position, open to applicants in Illinois, +1 more state.

📋 Description

• Act as a subject-matter expert on reimbursement, access, and coverage matters.

• Educate healthcare providers, office personnel, and practice managers regarding insurance, reimbursement, coding, billing, formulary, prior authorization, and appeals processes.

• Facilitate patient access to client products by addressing reimbursement and coverage obstacles.

• Collaborate with patient assistance and reimbursement support services.

• Serve as a liaison among providers, manufacturers, pharmacies, and payers.

• Update office staff on changes in coverage and payer policies within designated territories.

• Investigate office procedures to uncover the root causes of access or reimbursement challenges.

• Deliver engaging educational presentations at provider service locations.

• Provide approved reimbursement details pertinent to client products.

• Carry out other related responsibilities as assigned.

⛳️ Requirements

• Must reside within a reasonable commuting distance from a major airport in Illinois, Indiana, or Michigan.

• Willingness to travel up to 50% within the territory encompassing Indiana, Michigan, and Illinois.

• Regular travel is expected, which may include overnight stays.

• High School Diploma or GED is required.

• Prior experience in healthcare resolving pharmacy benefit access issues is essential.

• Proven experience with frequent travel.

• Background in revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes is necessary.

• Familiarity with specialty pharmacy operations is important.

• Comprehensive understanding of pharmacy benefits and policies is required.

• Proficient in Microsoft Word, PowerPoint, Excel, and Outlook.

• Strong skills in time management and planning are essential.

• Must be willing to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment.

• A Bachelor's degree or relevant experience in practice management is preferred.

• Prior experience as a Field Reimbursement Manager/Specialist is preferred.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Backup dependent care services.

• Adoption assistance programs.

• Coverage for infertility treatments.

• Support for family building.

• Solutions for behavioral health.

• Paid parental leave.

• Paid caregiver leave.

• Training and development programs.

• Resources for professional growth.

• Mentorship initiatives.

• Employee resource groups.

• Opportunities for volunteer activities.