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Role Description

Field Reimbursement Specialists (FRSs) are responsible for providing field support for patient access to client’s specified products through interaction with the client’s patient support program and provider customers.

• Provide expertise and advanced skills to resolve complex patient access and provider reimbursement issues.
• Deliver educational services across a variety of healthcare provider sites of care.
• Work directly with providers and their office support staff.
• Interact with other reimbursement and patient support services provided by clients.
• Help patients gain access to life-changing therapies, including oral medications, biosimilars, and critical cancer treatments.
• Plan and engage with customers to educate on access and reimbursement topics relevant to assigned client’s product.
• Manage daily activities that support appropriate patient access to client’s products in provider offices.
• Act as a liaison to other patient assistance and reimbursement support services offered by clients.
• Travel weekly, which may include overnight stays, to healthcare offices within a designated territory.
• Educate provider office staff and practice managers on logistics needed to support client product.
• Probe to understand office processes and 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 client’s products based on client’s approval.
• Perform other related duties as assigned.

Qualifications

• High School Diploma/GED required.
• Bachelor's degree or specific Practice Management experience preferred.
• Project management skills.
• Experience with extensive travel.
• Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment.

Requirements

• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
• Understanding of 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.

Benefits

• Comprehensive compensation, benefits, and resources that enable a highly inclusive culture.
• Traditional offerings like medical, dental, and vision care.
• Support for working families, including backup dependent care, adoption assistance, infertility coverage, and family building support.
• Behavioral health solutions, paid parental leave, and paid caregiver leave.
• Variety of training programs, professional development resources, and opportunities to participate in mentorship programs and volunteer activities.