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Field Reimbursement Manager - Travel (MD, VA, NC)

HERNDON, VA

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Description

Our client is a huge name in the global healthcare industry and adding to the team. FRM assigned to a manageable territory.   

Live anywhere in NC, VA, MD and travel within your territory.  

 

We are looking for an Expert in Reimbursement Buy & Bill for Specialty Drugs

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. Office interaction will include:

Educate:

  • Benefit Investigation / Prior Authorization Process
  • Support Center Services
  • Medicare and Commercial coverage
  • Educate on the patient communication streams

Reimbursement Support:

  • 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: outbound calls to set up appointments to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information. Travel M-Thu.

Monitor program performance for physicians and manufacturer representatives in accordance with expectations.

Research and compile provider / manufacturer representative specific information for reimbursement database.

Utilize internal resources to proactively address areas of opportunity related to the overall customer experience.

Utilize performance tracking tools & survey

Job Requirements

Minimum Requirements

  • BA degree in Business or Healthcare or a minimum of 8 years healthcare related reimbursement experience and 2 years as a field /territory reimbursement advocate
  • Medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
  • Experience in the healthcare industry including, but not limited to 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
    • Must include PowerPoint
    • Must include Web Meeting experience

Summary - the best candidate for this role will have knowledge in PA’s, copay, denials, payer knowledge, coding, J-Codes, and EOBs

  • Previous territory experience
  • Account management experience
  • Excellent Interpersonal skills verbal and written
  • Sense of customer advocacy
  • Not a sales job!

Interviewing immediately for an ASAP start date. 90 DAY TEMP TO HIRE ROLE

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