What are the responsibilities and job description for the Field Reimbursement Specialist position at RemX | The Workforce Experts?
Field Reimbursement Specialist
Seeking a dedicated expert in Retail and Specialty pharmacy drug Prior Authorizations, Appeals, and handling denials, with a strong background in managing FRM territories and training provider office staff.
This is a FIELD / TRAVEL position covering the territory of Seattle, WA .
The ideal candidate will :
- Possess proven FRM territory experience (with strong understanding of working without PHI access).
- Demonstrate a genuine commitment to patient advocacy by overcoming challenges to ensure medications are approved and reimbursed.
- Bring expertise in Retail Pharmacy and Specialty Drug Prior Authorizations , including navigating portals, conducting benefits investigations, and resolving appeals and denials.
- Have knowledge of the local payor landscape , including Medicare & Medicaid.
- Understand effective strategies to manage situations when PHI is unavailable.
- Exhibit experience in escalations, education, Commercial co-pay card approvals, Patient Assistance program approvals, Foundation coverage, and reimbursement guidelines . Stay updated on changes in drug programs, new FDA indications, J-codes, and payer policy alterations affecting reimbursement.
