Field Reimbursement Manager
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Job Description
Field Reimbursement Manager supporting CoverMyMeds drug reimbursement and patient services. Educating physician offices and managing territory-based reimbursement support for McKesson.
Responsibilities:
- Manage an assigned territory supporting reimbursement and patient services for a specific drug
- Assist with patient reimbursement challenges, including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals
- Educate physician offices on payer landscape and available services through remote interaction and on-site training
- Build relationships with physician offices and manufacturer representatives
- Provide on-site and on-demand education, including Lunch and Learns or Dinner presentations
- Conduct an average of 15 on-site/virtual interactions per week and record activities in FRM CRM daily
- Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and patient communication streams
- Provide reimbursement support for case management, billing and coding updates, claims submission, Specialty Pharmacy, Medical Benefit Interpretation, medical necessity, claims and appeals, co-pay assistance, and patient assistance programs
- Collaborate with case managers on an average of 4 cases per month and handle escalations as needed
- Set up appointments and complete outbound calls to targeted offices
- Assist with backlog casework and day-to-day in-office work
- Interface with physicians and manufacturer representatives to exchange patient- and provider-specific information
- Monitor program and territory performance through FRM CRM dashboards and reporting
- Research and compile provider/manufacturer representative information and create facility databases in FRM CRM
Requirements:
- 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
- Healthcare industry experience, including insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
- Medicare and commercial insurance coverage experience
- Ability to deliver and document benefit investigation outcomes and relay status reports regularly
- Proven presentation skills and experience
- Ability to effectively handle multiple priorities and excellent organizational skills
- Strong computer literacy, including PowerPoint and Web Meeting experience
- Excellent interpersonal skills
- Excellent written and oral communication skills
- Problem solving and decision-making skills
- Must reside in the territory
- Must be able to travel 80% (4 days a week) via automobile or plane
- Must have a valid driver's license with a clean driving record/MVR
Benefits:
- Competitive compensation package
- Annual bonus or long-term incentive opportunities may be offered
- Equal employment opportunities
- Reasonable accommodation for job seekers with disabilities
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