Senior Field Reimbursement Specialist ID-11572
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Activities may include, but are not limited to:Review patient insurance benefit options with appropriate authorizationsValidate prior authorization requirementsUnderstanding of Specialty Pharmacy processesEducate provider office staff and practice managers on coordination 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.Identify alternate funding/financial assistance programsAct as SME about coverage, specific product codes, including patient-specific access questions.
Effective account management: uncovering customer insights through effective questioning; critical thinking and problem solving; disseminating data and information to partners.Review appropriate billing and coding for productsProbe to understand office processes and ability to discern root causes of access or reimbursement issuesDrive resolving reimbursement issues through an educational approachCollaborate with our client’s patient services program representativesEducate physician office staff on the use of our client’s patient assistance and support line reimbursement support services, including web-based provider programs
Deliver interactive educational presentations at various provider sites of serviceProvide information on relevant reimbursement topics related to our client’s products based on client’s approvalCommunicate and collaborate with client cross-functional teams to include but not limited to sales representatives, account managers and district managers based on established rules of engagementPrioritize activities and abide by processes to maximize effective coverage of accounts and track progress while adhering to policies, procedures, and performance metricsLeverage reimbursement knowledge and utilize resources to aid accounts and effectively build customer partnershipsLead internal team training and meetingsServe as a peer buddy and mentor to colleaguesLead geography support for team members and managerDevelop and execute business plan for assigned territoryPerforms other related duties as assigned.
Education and Experience:Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support. Experience within healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred.Professional experience:Bachelor’s degree preferred.
Minimum of 7 years of experienceSkills and Knowledge:Ability to effectively manage multiple client relationships (e.g., field sales, payer team, support services vendor representatives) and customerAbility to manage and support external meetings, presentations, and client interactionsAbility to lead and work in a matrix environmentProven teamwork and collaboration skills with a demonstrated record of accomplishment of working in highly matrixed and cross-functional organizationsAbility to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the roles and responsibilities of a Field Reimbursement SpecialistsAbility to effectively work with other client’s program vendors to deliver a positive customer experienceSound Judgment and decision-making ability with a high degree of emotional intelligenceCreative problem-solving skillsAbility to effectively manage competing priorities with a keen sense of urgency.
