Field Reimbursement Specialist

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

📋 Description

• Provide education to healthcare providers, office personnel, and practice managers regarding reimbursement, access, insurance, coding, billing, formulary, prior authorization, and appeal processes.

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

• Collaborate with patient assistance and reimbursement support services available from the client.

• Update provider offices on changes in coverage and payer policies within assigned regions.

• Analyze office processes and determine underlying causes of access or reimbursement issues.

• Conduct engaging educational presentations at provider service locations.

• Supply approved reimbursement information associated with client products.

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

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

• Perform additional related duties as assigned.

⛳️ Requirements

• A High School Diploma/GED is required.

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

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

• Previous healthcare experience directly addressing pharmacy benefit access issues is essential.

• Must have experience with frequent travel.

• Familiarity with revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes is required.

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

• Knowledge of specialty pharmacy dynamics is important.

• Ability to provide field-based reimbursement and access support, education, and consultation is crucial.

• Strong time management and organizational skills are needed.

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

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

• Willingness to travel up to 80% within a designated territory, including Nashville, Knoxville, Springfield, North Alabama, Southern Illinois, and Kentucky.

• Commitment to obtaining Prior Authorization Certified Specialist (PACS) certification within the first six months of employment.

🏝️ Benefits

• Medical, dental, and vision care

• Backup dependent care

• Adoption assistance

• Infertility coverage

• Family building support

• Behavioral health solutions

• Paid parental leave

• Paid caregiver leave

• Training programs

• Professional development resources

• Mentorship programs

• Employee resource groups

• Volunteer activities