Field Reimbursement Specialist

Cencora•Long Island, NY

10d•Onsite

About The Position

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today! Job Details Please note: Interested candidates must live within a reasonable commuting distance of a major airport in the listed location and be able to travel up to 80% within a territory that includes but may not be limited to New York City, NY, Brooklyn, NY, Queens, NY, and Long Island, NY. Field Reimbursement Specialists(FRSs) are responsible for providing field support for patient access to client’s specified products through interaction with the client’s patient support program and provider customers. FRSs provide their expertise and advanced skills to resolve complex patient access and provider reimbursement issues and to provide educational services across a variety of healthcare provider sites of care. FRSs work directly with the provider and their office support staff and commonly interact with other reimbursement and patient support services provided by clients. Play a vital role in helping patients gain access to life changing therapies! From oral medications to biosimilars to critical cancer treatments, our associates, with their passion for patients, represent these therapies providing education, coverage, and access solutions to healthcare personnel. FRSs will plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to assigned client’s product. The FRS will manage daily activities that support appropriate patient access to our client’s products in the provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Our teams travel weekly, which could include overnight, to healthcare offices within a designated territory, using their knowledge of coverage, patient assistance, and health policy to educate office staff and break through access issues to ultimately help patients. As an FRS, a typical day might include: Educate provider office staff and practice managers on logistics needed to support client product, including infrastructure needed to support in-office administration including buy and bill and monitoring of product, and important coverage and payer policy changes within assigned territories. Educate provider office staff with understanding the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes. Probe to understand office processes and ability to discern root causes of access or reimbursement issues Deliver interactive educational presentations at various provider sites of service Provide information on relevant reimbursement topics related to our client’s products based on client’s approval Performs other related duties as assigned.

Requirements

Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution
Broad understanding of the physician buy-and-bill model vs. assignment of benefits to alternate sites of care.
Experience in revenue cycle, buy and bill (including billing with miscellaneous J-code), formulary, benefit investigations, prior authorization, coding, and appeals processes
Deep understanding of medical and pharmacy benefits/policies.
Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that includes but may not be limited to New York City, NY, Brooklyn, NY, Queens, NY, and Long Island, NY.
High School Diploma/GED required.
Bachelor's degree or specific Practice Management experience preferred.
Project management skills
Experience with extensive travel
Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment.

Nice To Haves

Bachelor's degree or specific Practice Management experience preferred.

Responsibilities

Educate provider office staff and practice managers on logistics needed to support client product, including infrastructure needed to support in-office administration including buy and bill and monitoring of product, and important coverage and payer policy changes within assigned territories.
Educate provider office staff with understanding the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes.
Probe to understand office processes and ability to discern root causes of access or reimbursement issues
Deliver interactive educational presentations at various provider sites of service
Provide information on relevant reimbursement topics related to our client’s products based on client’s approval
Performs other related duties as assigned.

Benefits

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day.
In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness.
This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave.
To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

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