Field Reimbursement Manager
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Job Description
Field Reimbursement Manager supporting reimbursement and patient services for specific drugs at McKesson, a healthcare products and services company. Educating physician offices and managing field-based reimbursement support.
Responsibilities:
- Manage an assigned territory supporting reimbursement and patient services for a specific drug
- Assist with 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
- Collaborate with internal program hub support services to meet customer needs
- Arrange site visits, manufacturer trainings, and educational training venues by telephone
- Provide on-site and on-demand education, including Lunch and Learns or Dinner presentations
- Provide reimbursement education and support through on-site and virtual interactions averaging 15 per week
- Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and patient communication streams
- Support case management, billing and coding updates, claims submission, Specialty Pharmacy, Medical Benefit Interpretation, medical necessity, claims and appeal assistance, co-pay assistance, and patient assistance programs
- Collaborate with case managers on average 4 times per month and as needed for escalations
- Set appointments and complete outbound calls to targeted offices
- Assist with backlog casework and additional day-to-day in-office work
- Interface with physicians and manufacturer representatives to exchange patient- and provider-specific information
- Track interactions and activities in FRM CRM and hub systems for management and client reporting
- Monitor program performance using FRM CRM dashboards and quarterly reporting
- Research and compile provider/manufacturer representative information for the reimbursement database
- Create a facility database for each new provider in FRM CRM
Requirements:
- Candidate must live within the Chicago, IL and Detroit, MI area
- 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
- Experience in the healthcare industry including insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
- Must have Medicare and commercial insurance coverage experience
- Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis
- Proven presentation skills and experience
- Proven ability to effectively handle multiple priorities and excellent organizational skills
- Strong computer literacy, including PowerPoint and Web Meeting experience
- Previous field experience, a plus
- Previous experience with specialty pharmacy, a plus
- Account management experience, a plus
- Excellent interpersonal skills
- Excellent written and oral communication skills
- Problem solving and decision-making skills
- Must reside in territory: Chicago, IL and Detroit, MI
- 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 may be offered
- Long-term incentive opportunities may be offered
- Total Rewards package
- Equal employment opportunities
- Reasonable accommodation for job search or application
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