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Field Reimbursement Manager -Remote from home (TX, La, AR, MS)

HOUSTON, TX

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Description

Our client is a huge name in the global healthcare industry and adding to the team. You will start with a specific pharmaceutical product, then add to your portfolio as you grow.

Work from home! Live anywhere in the Region (TX, La, MS, AR)

Must be an Expert in Health Insurance Billing & Reimbursement for SPECIALTY DRUGS

Key Responsibilities:Provide virtual and on-demand education 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 (again, for Specialty Drugs)
  • Support Center Services
  • Medicare and Commercial coverage
  • Educate on the patient communication streams

Reimbursement Support:

  • Case management - 100% focus on the process for Specialty drugs)
  • 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 setting up phone and virtual appointments and completing outbound calls 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.

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.

Job Requirements

Minimum Requirements

  • BA degree in Business or Healthcare or a minimum of 8 years specialty drug related reimbursement experience and 1 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

The best candidate for this role will have

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

Interviewing immediately for a May start date. True temp to hire role

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