Job Description

Job Description

Job Description

FIELD REIMBURSEMENT MANAGER, Various with focus on hospitals.

Travel territory position, visiting Hospitals and provider offices all around your territory

A MUST : Expert level in Prior Authorizations for Specialty Drugs, Access and Reimbursement , Patient Access to drug therapies. Newly launched specialty drug (already launched). Some kind of field experience.

Live in the territory , travel to hospitals and community providers around your territory .

Key Responsibilities:

Provide on-demand education (in-person and virtual) for the doctor's office staff in regard to Reimbursement challenges and support services that are available for these Specialty Drugs and Buy & Bill drugs.

Educate the provider's office team :

• Benefit Investigation / Prior Authorization Process for the specialty drugs.
• Support Center Services (hub)
• Medicare and Commercial coverage
• Educate on the patient communication streams

Provide Reimbursement Support:

• Drug Therapy Case management
• Billing and coding updates
• Appropriate claims submission
• Specialty Pharmacy
• Medical Benefit Interpretation
• Understanding medical necessity
• Claims / Appeal assistance
• Information related to co-pay assistance programs
• Information related to patient assistance programs

Responsible for managing your territory: making outbound calls to set up appointments to targeted offices.

• In person and in virtual meetings and calls: Interface with physician's Office Staff and MA's and Drug Manufacturer Reps to obtain and provide patient and provider specific information.
• Assist in completing backlog casework.
• Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
• Research and compile provider / manufacturer representative specific information for reimbursement database.
• Travel Days are Tues, Wed, Thurs (by car or flight). Arrange your own appointments within your territory. Emphasis is on live in-person office visitations. Usually Tu - Thr with Mondays and Fridays your at home office days

Minimum Requirements

• We are a good home for an FRM looking for stability
• I'm looking for candidates with field/territory experience because that is the whole point of a Field Reimbursement Manager.
• BA degree or RELATED EXPERIENCE (WE LIKE THE FRM EXPERIENCE)
• 4-5 years specialty drug related reimbursement experience, reimbursement advocacy
• Medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
• Insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
• Medicare and commercial insurance coverage experience.
• Deliver and document benefit investigation outcomes and relay status reports on a regular basis.
• Ability to effectively handle multiple priorities within a changing environment.
• Strong Computer literacy, including MS Teams, PowerPoint, Web Meeting experience

Interviewing immediately for rolling September start dates. 

Company Description

The professional staffing division of EmployBridge, America's Leading Workforce Specialist:

When our Talent is looking for their next opportunity, we know they are not just looking for their next paycheck. Our Recruiters are experts in their specialized fields and understand that making the right match between the candidate and the company, is the key to long term success.

We are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Company Description

The professional staffing division of EmployBridge, America's Leading Workforce Specialist:\r\n\r\nWhen our Talent is looking for their next opportunity, we know they are not just looking for their next paycheck. Our Recruiters are experts in their specialized fields and understand that making the right match between the candidate and the company, is the key to long term success.\r\n\r\nWe are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Job Tags

Immediate start, Remote job, Home office, Monday to Friday,

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