Field Reimbursement Manager-Ophthalmology – Seattle, WA (PNW) & Portland, OR

Regeneron Pharmaceuticals • Seattle, WA

9d

About The Position

Field Reimbursement Manager (FRM), Ophthalmology – Seattle (PNW) The Field Reimbursement Manager is a critical front-line member of the Regeneron Ophthalmology Field team. You will use your expertise and knowledge with all Regeneron customers, both internal and external. In this role, you will support physician offices throughout all facets of the reimbursement cycle and work to ensure the lines of communication remain open for existing and future Regeneron products. We always do what is right and seek to fully understand provider business drivers to help develop compliant approaches to account issues and management. In this role, a typical day many include: Develop and execute account plans that build reimbursement confidence with customers (e.g. MD and staff) & support continued patient access. Proactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers. Develop collaborative relationships with Regeneron colleagues (ex. Regional Directors and Medical Specialists) to educate physician offices in coverage/coding of Regeneron products and support patient access to care. Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes. Anticipate and adapt to the customer’s needs, as well as market changes and challenges. Demonstrate proactive planning and time management skills by the efficient and effective coverage of your assigned RBM Territory. Establish positive working relationships with accounts (e.g. MD’s, Administrators & office staff) and effectively manage product concerns. Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize basket of company approved access materials to support reimbursement confidence.

Requirements

• Previous experience working with billing and medical claims personnel in various health care settings, including, but not limited to a physician office, hospital, HOPD or ASC.
• Shown expertise in supporting healthcare provider offices with coding, billing, and submissions in range of payer environments.
• Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives.
• Familiar with CPT, HCPCS, ICD-10, revenue codes and DRG, coverage.
• Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur.
• Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies.
• To be considered for this role, we expect you to have a bachelor's degree.
• 5-8 years' pharmaceutical/biotech/device experience, including minimum of 3-5 years healthcare coverage, coding and/or reimbursement experience.
• Worked with products delivered through a Specialty Pharmacy network.
• Candidate must reside within assigned territory and have ability to travel 50%-70% of the time.

Responsibilities

• Develop and execute account plans that build reimbursement confidence with customers (e.g. MD and staff) & support continued patient access.
• Proactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers.
• Develop collaborative relationships with Regeneron colleagues (ex. Regional Directors and Medical Specialists) to educate physician offices in coverage/coding of Regeneron products and support patient access to care.
• Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes.
• Anticipate and adapt to the customer’s needs, as well as market changes and challenges.
• Demonstrate proactive planning and time management skills by the efficient and effective coverage of your assigned RBM Territory.
• Establish positive working relationships with accounts (e.g. MD’s, Administrators & office staff) and effectively manage product concerns.
• Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize basket of company approved access materials to support reimbursement confidence.

Benefits

• health and wellness programs (including medical, dental, vision, life, and disability insurance)
• fitness centers
• 401(k) company match
• family support benefits
• equity awards
• annual bonuses
• paid time off
• paid leaves (e.g., military and parental leave)

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees