Field Reimbursement Manager

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 interactions 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 Provide on-site and on-demand education, including Lunch and Learns or Dinner presentations Conduct office education and reimbursement support through on-site and virtual interactions averaging 15 per week Educate on Benefit Investigation, Prior Authorization, 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 appeals, co-pay assistance, and patient assistance programs Collaborate with case managers on an average of 4 cases per month and as needed for escalations 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 obtain and provide patient- and provider-specific information Track all interactions and activities in FRM CRM and report to management and clients Monitor territory and program performance using the FRM CRM dashboard and quarterly reporting Research and compile provider/manufacturer representative information for the reimbursement database Create facility databases for new providers in FRM CRM Requirements Candidate must live within Orlando or Jacksonville, FL 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 Excellent interpersonal skills Excellent written and oral communication skills Problem solving and decision-making skills Must reside in the territory: Orlando or Jacksonville, FL 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 Core Competencies Demonstrates expertise in healthcare reimbursement processes, including Benefit Investigation, Prior Authorization, and claims management. Proven ability to educate and build relationships with healthcare providers while effectively managing multiple priorities. Highest-signal resume keywords Healthcare Reimbursement Experience Benefit Investigation Prior Authorization Presentation Skills Medicare and Commercial Insurance Coverage ATS Optimization Keywords Hard Skills Claims Assistance Medical Benefit Interpretation Billing and Coding Updates Co-Pay Assistance Patient Assistance Programs Insurance Verification Claim Adjudication Specialty Pharmacy Buy & Bill Database Creation Soft Skills Excellent Interpersonal Skills Organizational Skills Problem Solving Decision-Making Written and Oral Communication Skills Certifications & Qualifications Valid Driver's License Industry Keywords Healthcare Industry Patient Services Physician Offices Manufacturer Representatives Claims Submission Tools & Technologies FRM CRM PowerPoint Web Meeting #J-18808-Ljbffr