Field Reimbursement Manager - Cranston RI

Field Reimbursement Manager

In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and Reimbursement. This role involves supporting products by executing the collaborative territory strategic plan. The FRM will ensure an understanding of the reimbursement process, field reimbursement services, and patient support programs. They will also work on patient-level reimbursement issue resolution, requiring knowledge and experience with patient health information (PHI).

Act as an extension of the HUB, providing live one-on-one coverage support

Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms

Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges

Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access

Coordinate access/reimbursement issues with relevant partners, including the HUB

Provide information to HCPs on how the products are covered under the benefit design (Commercial, Medicare, Medicaid)

Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders

Offer office education during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution

Educate offices using approved materials

Review patient insurance benefit options and alternate funding/financial assistance programs

Collaborate with other departments to resolve reimbursement issues

Working Conditions:

3 days a week in geography for customer appointments, (geography specific)

General office demands Remote, Work from Home. One to two home office days per week.

Must be able to travel up to 60-80% via automobile or plane.

Must have a valid driver's license with a clean driving record.

Possible long periods of sitting and/or keyboard work.

National Guard Employment Network