Field Reimbursement Manager

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and/or account coordination based on client expectation. Key Responsibilities include providing on-site and on-demand education for office staff regarding reimbursement challenges and support services, educating on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and patient communication streams. The role involves reimbursement support on case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, claims and appeal assistance, and patient assistance programs. The FRM will collaborate with case managers and interface with physicians and manufacturer representatives to provide patient and provider specific information. The position requires monitoring program performance, researching and compiling provider/manufacturer representative information, and maintaining a reimbursement database. Minimum qualifications include a 4-year degree or equivalent experience, 4+ years of healthcare related reimbursement experience, strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy, and Medicare and commercial insurance coverage experience. The role requires excellent presentation, organizational, interpersonal, communication, problem solving, and decision-making skills. Travel up to 80% is required, and a valid driver's license with a clean driving record is necessary.