Field Reimbursement Specialist

Job Details

Please Note: Interested candidates must live within a reasonable commuting distance of a major airport in the listed location and be able to travel up to 80% within a territory that includes but may not be limited to Washington, Oregon, Northern California, and Northern Nevada.

About the Role

The Field Reimbursement Specialist (FRS) serves as a subject-matter expert on reimbursement, access, and coverage issues. The FRS plays a critical role in ensuring patients can access specialty medications by educating healthcare providers and their staff on complex insurance and reimbursement processes and resolving access barriers.

Responsibilities

• Educating providers and their office staff on access and reimbursement topics using client-approved resources.
• Supporting appropriate patient access to the client’s products by resolving reimbursement and coverage challenges.
• Collaborating with other patient assistance and reimbursement support services offered by the client.
• Weekly travel, including potential overnight stays, to healthcare offices within a designated territory.
• Delivering interactive educational presentations at various provider sites of service.
• Providing information on relevant reimbursement topics related to our client’s products based on client’s approval.

Requirements

• Expertise in pharmacy benefit reimbursement, prior authorizations, appeals, and specialty pharmacies.
• Experience in revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes.
• Strong time management and planning skills.
• Proficient in Microsoft Word, Powerpoint, Excel, and Outlook.

Skills

• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
• Understanding the dynamics of specialty pharmacy.
• Deep understanding of pharmacy benefits/policies.

Qualifications

• High School Diploma/GED required.
• Bachelor's degree or relevant practice management experience preferred.
• Previous experience as Field Reimbursement Manager/Specialist preferred.
• Previous experience working in healthcare directly resolving pharmacy benefit access issues.
• Experience with extensive travel.
• Candidates must be willing to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment.

Benefits

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

Pay

Full-time Salary Range: $93,500 - 187,000. This Salary Range reflects a National Average for this job. The actual range may vary based on your locale. Ranges in Colorado/California/Washington/New York/Hawaii/Vermont/Minnesota/Massachusetts/Illinois State-specific locations may be up to 10% lower than the minimum salary range, and 12% higher than the maximum salary range.

Schedule

Full-time position.