Senior Field Reimbursement Specialist

AmerisourceBergen • Washington, DC

299d • $98,200 - $151,360 • Remote

About The Position

The Senior Field Reimbursement Specialist will plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to assigned client's product. The role involves tracking progress and evaluating results of assigned activities, recommending changes in procedures, and leading or directing more complex projects. The Sr FRS will work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide appropriate education through a focused effort on healthcare providers in community, institutional, and academic medical settings. Daily activities include managing patient access to products, reviewing patient insurance benefits, validating prior authorization requirements, and educating provider office staff on necessary coordination and coverage management strategies.

Requirements

• Minimum of 7 years of experience in a medical practice, reimbursement arena, or pharmaceutical industry.
• Bachelor's degree preferred.
• Ability to manage multiple client relationships and external meetings.
• Proven teamwork and collaboration skills.
• Strong problem-solving skills and sound judgment.
• Excellent communication skills with the ability to present complex information.
• Broad understanding of the physician buy-and-bill model and medical/pharmacy benefits.
• Experience in revenue cycle, prior authorization, coding, and appeals processes.
• Knowledge of private payer, Medicare, and Medicaid structures.

Nice To Haves

• Experience within healthcare provider support such as a physician practice or patient assistance program.
• Deep understanding of Specialty Pharmacy vs. Specialty Distribution.
• Experience with pharmaceutical manufacturer patient support programs.

Responsibilities

• Plan and engage with customers to educate on access and reimbursement topics.
• Track progress and evaluate results of assigned activities.
• Lead or direct complex projects.
• Collaborate with internal and external stakeholders to secure optimized patient access.
• Manage daily activities supporting patient access to products.
• Review patient insurance benefit options and validate prior authorization requirements.
• Educate provider office staff on coordination needed to support client products.
• Identify alternate funding/financial assistance programs.
• Drive resolution of reimbursement issues through education.
• Deliver interactive educational presentations at provider sites.
• Communicate and collaborate with client cross-functional teams.
• Prioritize activities and track progress while adhering to policies and performance metrics.
• Lead internal team training and meetings.
• Develop and execute business plan for assigned territory.

Benefits

• Medical, dental, and vision care.
• Backup dependent care.
• Adoption assistance.
• Infertility coverage.
• Family building support.
• Behavioral health solutions.
• Paid parental leave.
• Paid caregiver leave.
• Training programs and professional development resources.
• Opportunities to participate in mentorship programs and volunteer activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Merchant Wholesalers, Nondurable Goods
• Education Level: Bachelor's degree