Field Reimbursement Manager
About The Position
The CoverMyMeds Field Reimbursement Manager (FRM) manages an assigned territory and supports reimbursement and patient services for a specific drug. The role helps address patient reimbursement challenges, including benefit investigations, prior authorizations, claims assistance, and appeals, while educating physician offices about payer landscapes and available services through remote interactions and on-site training. This client- and customer-facing role builds relationships with physician offices and manufacturer representatives and delivers services according to customer preferences. The FRM works independently in a fast-paced, highly visible environment and collaborates with internal program hub support services to meet customer needs. The position involves frequent telephone interactions to arrange site visits, manufacturer trainings, and educational events; a working knowledge of Medicare and commercial insurance plans and benefit structures; project management or account coordination; and travel. The role is remote and home-based, with the employee required to reside in the assigned territory and travel approximately 80% (four days a week) by automobile or plane. It involves general office work and may require prolonged sitting and keyboard use. Compensation is a base pay range of $72,200–$120,400; an annual bonus or long-term incentive opportunities may also be offered.
Requirements
- Four-year degree in a related field or equivalent experience.
- At least four years of healthcare-related reimbursement experience.
- Strong medical reimbursement experience with Buy & Bill and/or specialty pharmacy.
- Healthcare industry experience, including insurance verification, prior authorizations, claims adjudication, or work in a physician’s office or clinic.
- Experience with Medicare and commercial insurance coverage.
- Ability to deliver and document benefit investigation outcomes and regularly relay status reports.
- Proven presentation skills and experience.
- Ability to handle multiple priorities, with excellent organizational skills.
- Strong computer literacy, including PowerPoint and web meeting experience.
- Excellent interpersonal skills and written and oral communication skills.
- Problem-solving and decision-making skills.
- Must reside in the assigned territory.
- Must be able to travel 80% (four days a week) by automobile or plane.
- Valid driver’s license and clean driving record/MVR.
Nice To Haves
- Previous field experience.
- Previous specialty pharmacy experience.
- Account management experience.
Responsibilities
- Provide on-site and on-demand education to office staff about reimbursement challenges and available support services, including Lunch and Learns or dinner presentations.
- Conduct an average of 15 on-site or virtual interactions per week and record activities in the FRM CRM daily, with weekly reporting to the manager.
- Educate offices on benefit investigations, prior authorization processes, support center services, Medicare and commercial coverage, and patient communication streams.
- Report monthly educational activity and topics, and contribute to quarterly trend reporting to clients.
- Provide reimbursement support related to case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, copay assistance, and patient assistance programs.
- Collaborate with case managers an average of four times per month and as needed for escalations; track interactions in the FRM CRM and hub system.
- Set up appointments, make outbound calls to targeted offices, assist with backlog casework, and perform other day-to-day in-office work.
- Interface with physicians and manufacturer representatives to obtain and provide patient- and provider-specific information.
- Track FRM interactions and activities in the CRM for management and client reporting.
- Monitor physician and manufacturer representative program performance using the FRM CRM dashboard and identify trends for quarterly reporting.
- Research and compile provider- and manufacturer-representative-specific reimbursement information, including account profiles.
- Create a facility database entry in the FRM CRM for each new provider and use it to build and track interactions.
Benefits
- Competitive compensation package.
- Annual bonus or long-term incentive opportunities may be offered.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
