McKesson-posted 7 months ago
$88,300 - $147,100/Yr
Full-time • Mid Level
Remote
Merchant Wholesalers, Nondurable Goods

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and/or account coordination based on client expectation.

  • Provide on-site and on-demand education for the office staff in regard to Reimbursement challenges and support services that are available.
  • Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams.
  • Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs.
  • Responsible for setting up appointments and completing outbound calls to targeted offices.
  • Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
  • Research and compile provider / manufacturer representative specific information for reimbursement database.
  • 4-year degree in related field or equivalent experience
  • 4+ years of healthcare related reimbursement experience
  • Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
  • Experience supporting oncology products preferred
  • Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician's office or clinics.
  • Must have Medicare and commercial insurance coverage experience.
  • Proven presentation skills and experience
  • Proven ability to effectively handle multiple priorities and excellent organizational skills
  • Strong Computer literacy to include PowerPoint and Web Meeting experience
  • Previous field experience
  • Previous experience with specialty pharmacy
  • Account management experience
  • Competitive compensation package
  • Annual bonus or long-term incentive opportunities
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