Field Reimbursement Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Serve as an expert in reimbursement, access, and coverage matters

• Educate healthcare professionals, office personnel, and practice managers about insurance, reimbursement, coding, billing, formulary, prior authorization, and appeals processes

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

• Collaborate with client patient assistance and reimbursement support services

• Act as a connector between providers, manufacturers, pharmacies, and payers

• Inform office staff about significant coverage and payer policy updates within designated territories

• Investigate office procedures and determine root causes of access or reimbursement challenges

• Deliver engaging educational presentations at providers' sites of service

• Supply client-approved information regarding reimbursement topics

• Cover territories throughout the United States

• Carry out other related responsibilities as assigned

⛳️ Requirements

• High School Diploma/GED is mandatory

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

• Prior experience as a Field Reimbursement Manager/Specialist is desirable

• Previous experience in healthcare resolving pharmacy benefit access issues is a plus

• Willingness to travel extensively

• Capability to provide field-based reimbursement and access support, education, and consultation

• Understanding of specialty pharmacy dynamics

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

• In-depth knowledge of pharmacy benefits/policies

• Strong skills in time management and planning

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

• Reside within a reasonable commuting distance of a major U.S. airport and provide nationwide territory coverage

• Willingness to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment

• Flexibility to travel weekly, including potential overnight stays

🏝️ Benefits

• Medical, dental, and vision coverage

• 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 opportunities

• Employee resource groups

• Volunteer activities