Field Reimbursement Manager

Adecco Healthcare & Life Sciences is hiring a contract remote Field Reimbursement Manager for our Medical partner.

The anticipated hourly wage for this position is between $50 and $51. Hourly wage may depend upon experience, education, geographic location, and other factors.

Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Summary :

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting reimbursement and patient access by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and / or account coordination based on client expectation.

Job Duties :

Provide on-site and on-demand education for the office staff in regard to reimbursement challenges and support services that are available. Office interaction will include education and reimbursement support. On-site / virtual interactions will average 15 per week. These activities are recorded in FRM CRM daily with reporting to manager weekly.

Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly to client.

Reimbursement support, account management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs. FRM will collaborate with multiple stakeholders ensuring all parties are aligned to resolutions and outcomes.

Responsible for setting up appointments and completing outbound calls to provider offices. Additional day-to-day in-office work. Interface with physicians to obtain and provide patient and payer specific information. All FRM interactions / activities are tracked in FRM CRM which are reportable to management and client.

Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting. Additionally, clients have the option to survey customers on program performance.

Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles) FRM will create a facility database on each new provider in FRM CRM. All interactions / activities are built utilizing this database.

Minimum Job Qualifications (Knowledge, Skills, & Abilities) :

Education / Training -

4-year degree in related field or equivalent experience.

Business Experience -

Field Reimbursement experience

Entry-level experience in project management

Minimum of 8 years healthcare related reimbursement experience

Strong experience with Buy & Bill, Retail, and / or Specialty Pharmacy

Experience supporting : oncology products, neurology, dermatology, rheumatology, cardiology, etc (this is program specific need)

Experience in the healthcare industry including, but not limited to 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 speak to benefit investigation outcomes and relay status reports on a regular basis.

Strong customer service and problem resolution experience

Proven presentation skills and experience

Ability to effectively handle multiple priorities within a changing environment.

Excellent organizational skills

Strong Computer literacy to include PowerPoint and Web Meeting experience

Specialized Knowledge / Skills -

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

Working Conditions :

General Office Demands - Remote, WFH when not traveling

Travel Requirements

Must reside in territory

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

Pay Details : $50.00 to $51.00 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer / Veterans / Disabled

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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and / or security clearance requirements, including, as applicable :

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Salary : $50 - $51