Specialist, Access and Reimbursement

Job Title

Serve as a skilled specialist in advanced access knowledge and skills, partnering closely with Field Reimbursement Managers (FRMs) and Health Care Providers (HCPs) within assigned territories to optimize patient outcomes.

Responsibilities

• Collaborate with Field Reimbursement Managers (FRMs) and Health Care Providers (HCPs) in designated territories to enhance patient access and support positive health outcomes.
• Educate FRMs and HCPs on patient support programs, including tools and services for access and reimbursement. Inform them about resources available to resolve patient access challenges.
• Provide local expertise on plans and efficiently educate on all aspects of prior authorization, medical exception, and appeal processes within assigned region for all inbound and outbound calls.
• Develop and sustain relationships with relevant providers within the territory. Utilize strong communication skills to facilitate clear, concise, and efficient information exchanges with FRMs, HCPs, and other stakeholders.
• Take ownership of process improvement initiatives, continuously seeking ways to enhance system efficiencies and patient access strategies.
• Maintain an understanding of current business procedures, deviations, and case processing for all brands and channel sources, as needed.
• Utilize critical thinking to assess and prioritize workloads at the account level, ensuring optimal resource allocation and seamless operations.
• Monitor and streamline communication and interactions between stakeholders to promote efficiency and reduce redundancies.
• Meet or exceed department standards relative to performance metrics. Maintain a work environment that upholds privacy standards required by law and AbbVie policy. Understand and comply with all required training, including adherence to federal, state, and local laws, SPII policies and guidelines, and the policies and procedures of Complete Patient Access and AbbVie. Perform additional tasks, activities, and projects as deemed necessary by management.

Qualifications

• Bachelor's degree or Associate Degree in health sciences or business preferred. Comparable or relevant experience will be considered.
• 3-5 years of experience in the healthcare industry with knowledge in reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations.
• Demonstrated understanding of the rules, regulations and risks associated with provision of reimbursement support services. Demonstrated deep technical understanding of coverage, coding, payment and distribution of specialty products and the rules and regulations that govern provision of reimbursement support.
• Strong understanding of access and reimbursement support service centers and how to effectively interact in a compliant fashion.
• Thorough understanding of the technical payer policy processes, systems and requirements for coverage.
• Must have professional written and verbal communication skills to interact with and build and maintain relationships with all levels of the organization. Must maintain a positive service image at all times even when dealing with challenging issues and unsatisfied customers.

Additional Information

• The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future.
• We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees.
• This job is eligible to participate in our short-term incentive programs.

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.

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Pay Range: $65500 - 125500 USD

Where We Work

Role is primarily site- or office-based but can occasionally be performed remotely. Employees who are site/office-based and can occasionally perform their role virtually work both in the office and remotely*, following the policies and regulations in place at their location. US Employees must be in the office on Tuesday, Wednesday, and Thursday with flexibility to work remotely on Mondays and Fridays. Three days in the office is the minimum; some individuals or teams may require more in-office days due to meetings, business/project needs or their role.