Field Reimbursement Specialist

Description:

Interested candidates must Live within a reasonable commuting distance of a major airport in the listed location and be able to travel up to 80% within a territory that includes but may not be limited to NY, PA, CT, MA, and northern NJ.

Play a vital role in helping patients gain access to life changing therapies! From oral medications to biosimilars to critical cancer treatments, our associates, with their passion for patients, represent these therapies providing education, coverage, and access solutions to healthcare personnel.

Field Reimbursement Specialists (FRSs) will plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to assigned client’s product. The FRS will manage daily activities that support appropriate patient access to our client’s products in the provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Our teams travel weekly, which could include overnight, to healthcare offices within a designated territory, using their knowledge of coverage, patient assistance, and health policy to educate office staff and break through access issues to ultimately help patients.

As An FRS, a Typical Day Might Include
 

• Educate provider office staff and practice managers on logistics needed to support client product, including infrastructure needed to support in-office administration including buy and bill and monitoring of product, and important coverage and payer policy changes within assigned territories.
• Educate provider office staff with understanding the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes.
• Probe to understand office processes and ability to discern root causes of access or reimbursement issues
• Deliver interactive educational presentations at various provider sites of service
• Provide information on relevant reimbursement topics related to our client’s products based on client’s approval
• Performs other related duties as assigned.
• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
• Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution
• Broad understanding of the physician buy-and-bill model vs. assignment of benefits to alternate sites of care.
• Experience in revenue cycle, buy and bill (including billing with miscellaneous J-code), formulary, benefit investigations, prior authorization, coding, and appeals processes
• Deep understanding of medical and pharmacy benefits/policies.
• Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that includes but may not be limited to NY, PA, CT, MA, and northern NJ.
   

Nice To Have
 

• High School Diploma/GED required.
• Bachelor's degree or specific Practice Management experience preferred.
• Project management skills
• Experience with extensive travel