What are the responsibilities and job description for the Field Reimbursement Specialist - Birmingham AL position at VetJobs?
Job Description
ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Unless specifically stated otherwise, this role is "On-Site" at the location detailed in the job post.
Let’s do this. Let’s change the world. In this vital role the Field Reimbursement Specialist (FRS) 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 FRS 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.
Auto req ID
441786BR
Minimum Education Required
High School/GED
Job_Category
Maintenance
Additional Qualifications/Responsibilities
We are all different, yet we all use our unique contributions to serve patients. The field reimbursement professional we seek is a collaborator with these qualifications.
Basic Qualifications
Doctorate degree AND 2 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
OR
Master’s degree AND 6 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
OR
Bachelor’s degree AND 8 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
OR
Associate degree AND 10 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
Preferred Qualifications
Bachelor's degree in business, healthcare, or a related field
6 years' experience with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products
Advanced knowledge of medical insurance terminology
Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B – for buy & bill products and Part D for Pharmacy products).
Ability to manage ambiguity and problem-solve
Ability to manage expenses within allocated budgets
Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge
Proven presentation and facilitation skills
Strong written and oral communication skills
Organizational skills and project management experience, including the ability to manage multiple projects
Strong computer literacy, including Word, Excel, and PowerPoint, and the ability to conduct web-based meetings
Experience in the healthcare industry, including insurance verification, claim adjudication, physician's offices or clinics, pharmacies, and/or pharmaceutical manufacturers
What you can expect of us
As we work to develop treatments that take care of others, we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture, we’ll support your journey every step of the way.
The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is $155,968.00 to $173,578 .00. Actual salary will vary based on several factors including, but not limited to, relevant skills, experience, and qualifications.
City*
Birmingham
State*
Alabama
Job Code
Pharmaceutical Pharmaceutical
Affiliate Sponsor
Amgen
Salary Range
>$100,000
ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Unless specifically stated otherwise, this role is "On-Site" at the location detailed in the job post.
Let’s do this. Let’s change the world. In this vital role the Field Reimbursement Specialist (FRS) 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 FRS 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.
Auto req ID
441786BR
Minimum Education Required
High School/GED
Job_Category
Maintenance
Additional Qualifications/Responsibilities
We are all different, yet we all use our unique contributions to serve patients. The field reimbursement professional we seek is a collaborator with these qualifications.
Basic Qualifications
Doctorate degree AND 2 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
OR
Master’s degree AND 6 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
OR
Bachelor’s degree AND 8 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
OR
Associate degree AND 10 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
Preferred Qualifications
Bachelor's degree in business, healthcare, or a related field
6 years' experience with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products
Advanced knowledge of medical insurance terminology
Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B – for buy & bill products and Part D for Pharmacy products).
Ability to manage ambiguity and problem-solve
Ability to manage expenses within allocated budgets
Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge
Proven presentation and facilitation skills
Strong written and oral communication skills
Organizational skills and project management experience, including the ability to manage multiple projects
Strong computer literacy, including Word, Excel, and PowerPoint, and the ability to conduct web-based meetings
Experience in the healthcare industry, including insurance verification, claim adjudication, physician's offices or clinics, pharmacies, and/or pharmaceutical manufacturers
What you can expect of us
As we work to develop treatments that take care of others, we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture, we’ll support your journey every step of the way.
The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is $155,968.00 to $173,578 .00. Actual salary will vary based on several factors including, but not limited to, relevant skills, experience, and qualifications.
City*
Birmingham
State*
Alabama
Job Code
Pharmaceutical Pharmaceutical
Affiliate Sponsor
Amgen
Salary Range
>$100,000
Salary : $155,968 - $173,578
