Field Reimbursement Specialist

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

📋 Description

• Develop and interact with customers utilizing client-approved materials to inform them about access and reimbursement issues related to assigned client products.

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

• Serve as a point of contact for patient assistance and reimbursement support services provided by clients.

• Travel weekly, occasionally requiring overnight stays, to healthcare facilities within a designated region.

• Train provider office personnel and practice managers on logistics for product support, in-office administrative processes, the buy-and-bill model, product monitoring, and updates on coverage and payer policy.

• Instruct provider office staff on strategies for managing payer coverage, including coding, billing, formulary options, prior authorizations, and appeal procedures.

• Analyze office workflows to identify the underlying causes of access or reimbursement challenges.

• Conduct engaging educational presentations at various provider service locations.

• Supply client-approved information on pertinent reimbursement subjects.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Must reside within the designated territory: North Carolina, South Carolina, or Georgia.

• Willingness to travel up to 80% within the specified region, including overnight stays.

• Capability to provide field-based reimbursement and access support, education, and consultation to key account clients and cross-functional teams.

• Familiarity with Specialty Pharmacy compared to Specialty Distribution.

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

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

• Profound knowledge of medical and pharmacy benefits/policies.

• High School Diploma or GED is required.

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

• Project management skills are necessary.

• Experience with significant travel is expected.

• Bilingual candidates are preferred, but not required.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Backup dependent care services.

• Adoption support.

• Infertility treatment coverage.

• Family building assistance.

• Behavioral health resources.

• Paid parental leave.

• Paid caregiver leave.

• Training and development programs.

• Professional growth resources.

• Mentorship opportunities.

• Employee resource groups.

• Volunteering opportunities.