Field Reimbursement Specialist
About The Position
The Field Reimbursement Specialist (FRS) serves as a subject-matter expert on reimbursement, access, and coverage issues, helping patients access specialty medications by educating healthcare providers and their staff on complex insurance and reimbursement processes and resolving access barriers. The FRS acts as a liaison among providers, manufacturers, pharmacies, and payers, and provides education on reimbursement and access considerations specific to a specialty medication. Expertise in pharmacy benefit reimbursement, prior authorizations, appeals, and specialty pharmacies is essential because the supported medication is typically covered under pharmacy benefits. The position involves weekly travel, including potential overnight stays, to healthcare offices in a territory that may include Colorado, Utah, Eastern Washington, Montana, Idaho, New Mexico, West Texas, Oklahoma, and Wyoming. Candidates must live within a reasonable commuting distance of a major airport in the listed location and be able to travel up to 80%. Cencora describes its benefits and resources as supporting team members’ physical, emotional, financial, and social wellness. Offerings may include backup dependent care, adoption assistance, infertility coverage, family-building support, behavioral health solutions, paid parental leave, paid caregiver leave, training, professional development, mentorship programs, employee resource groups, and volunteer activities.
Requirements
- High school diploma or GED.
- Experience working in healthcare directly resolving pharmacy benefit access issues.
- Experience with extensive travel.
- Ability to provide field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
- Understanding of specialty pharmacy dynamics.
- Experience in revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes.
- Deep understanding of pharmacy benefits and policies.
- Strong time management and planning skills.
- Proficiency in Microsoft Word, PowerPoint, Excel, and Outlook.
- Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within the assigned territory, potentially up to 80%, including overnight stays.
- Willingness to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment.
Nice To Haves
- Bachelor’s degree or relevant practice management experience.
- Previous experience as a Field Reimbursement Manager or Specialist.
Responsibilities
- Educate healthcare provider office staff and practice managers on insurance issues relevant to the supported product and communicate important coverage and payer policy changes within assigned territories.
- Educate provider office staff on payer coverage-management strategies, including coding, billing, formulary, prior authorization, and appeals processes.
- Understand office processes and identify root causes of access or reimbursement issues.
- Deliver interactive educational presentations at provider sites of service.
- Provide client-approved information on relevant reimbursement topics related to the client’s products.
- Support appropriate patient access to client products by resolving reimbursement and coverage challenges.
- Collaborate with other patient assistance and reimbursement support services offered by the client.
- Perform other related duties as assigned.
Benefits
- Medical, dental, and vision care.
- Backup dependent care may be available.
- Adoption assistance.
- Infertility coverage and family-building support.
- Behavioral health solutions.
- Paid parental leave.
- Paid caregiver leave.
- Training programs and professional development resources.
- Mentorship programs.
- Employee resource groups.
- Volunteer activities.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
