Field Reimbursement Specialist

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

📋 Description

• Educate healthcare providers, office personnel, and practice administrators on topics such as insurance, reimbursement, access, coding, billing, formulary, prior authorization, and appeals processes.

• Assist in facilitating patient access to client products by addressing reimbursement and coverage challenges.

• Collaborate with patient assistance and reimbursement support services provided by the client.

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

• Update office staff on significant coverage and payer policy changes within designated territories.

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

• Conduct engaging educational presentations at various provider service locations.

• Share client-approved information regarding reimbursement topics that pertain to client products.

• Travel weekly, which may include overnight stays, to healthcare offices within the specified territory.

• Execute other related tasks as assigned.

⛳️ Requirements

• A High School Diploma or GED is required.

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

• Previous experience as a Field Reimbursement Manager or Specialist is preferred.

• Prior experience in healthcare addressing pharmacy benefit access issues is required.

• Willingness to travel extensively is essential.

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

• Capability to deliver field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.

• Understanding of specialty pharmacy dynamics is necessary.

• Experience in revenue cycle management, formulary, benefit investigations, prior authorization, coding, and appeals processes is required.

• A comprehensive understanding of pharmacy benefits and policies is needed.

• Strong time management and organizational skills are essential.

• Proficiency in Microsoft Word, PowerPoint, Excel, and Outlook is necessary.

• Must reside within a reasonable commuting distance of a major airport in the specified location.

• Ability to travel up to 80% within the designated territory is required.

🏝️ Benefits

• Medical, dental, and vision care.

• Backup dependent care.

• Adoption assistance.

• Coverage for infertility treatments.

• Support for family building.

• Solutions for behavioral health.

• Paid parental leave.

• Paid caregiver leave.

• Access to training programs.

• Resources for professional development.

• Mentorship programs.

• Employee resource groups.

• Opportunities for volunteer activities.