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The Field Reimbursement Manager (FRM) is a field-based non-promotional position who will use their extensive knowledge of insurance coverage, patient assistance programs, and the local reimbursement landscape to provide support to Healthcare Professional's offices and their patients to obtain appropriate access to Bausch + Lomb's products.
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The Senior Reimbursement Analyst provides decision support to operating and senior management, including: gross and net patient revenue operations, budget and forecast reviews. The Senior Reimbursement Analyst is responsible for the completion of external cost reports, including data gathering, analysis, and audit support.
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The Field Reimbursement Manager is a part of the Customer Transformation team and reports directly to the EVP of Customer Transformation. The Field Reimbursement Manager supports the Kerecis field sales team, customers, and internal Benefits Investigation (BI) team on all reimbursement issues and inquiries.
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Minimum of two years of experience in public or private third-party reimbursement; previous field reimbursement manager experience preferred. Must possess an understanding of reimbursement considerations from a patient and provider perspective, with an ability to effectively interact and navigate within various sites of care (i.e., physician office, hospital outpatient department, ambulatory surgery center, etc.
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Negotiates reimbursement with third party carrier Medical Directors and insurance representatives. Negotiates surgical reimbursement with third carrier Medical Directors. Confers with department Chairs and other leadership on a regular basis to discuss billing/reimbursement concerns and changes in regulations.
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The Field Reimbursement Manager will be responsible for the management of defined accounts in Urology and Oncology area, specifically supporting our client's product. The Field Reimbursement Manager will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including acting as an extension of patient support program and in other collaboration with other partners.
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The Reimbursement Manager will also work on patient level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI), navigating access issues, and working with payer and NCCN guidelines for product utilization.
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Reimbursement Analyst II (RA II) reports to the Supervisor of the Department of Family and Protective Services (DFPS) Rates Team within Long-Term Services and Supports (LTSS) section of the Provider Finance Department (PFD) and performs advanced (senior-level) rate analysis work on reimbursement payment rates.
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ARM will serve as the key contact and lead for access and reimbursement support-related matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.
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This role supports Bausch + Lomb's retina product portfolio and business reimbursement strategy and requires strong skills in navigating across multiple functions and departments and among program vendors to provide an excellent customer experience.
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Must have worked with a pharmaceutical, biotech, or device manufacturer sales team in a reimbursement capacity or as a contract position through a reimbursement consulting agency. Must have general payer policy knowledge including public and private payers, foundational knowledge of benefit verifications and prior authorization/pre-determination requirements and knowledge of reimbursement processes within various sites of care.
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Experience with reimbursement billing, coding, and appeals process. Knowledge of private payer, Medicare and Medicaid structure, systems, and reimbursement process. Lead sales training related to product reimbursement, as appropriate.
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Keywords: MDS, pdpm, mds 3.0, registered nurse, rn, mds coordinator, regional director of clinical reimbursement, regional mds nurse, rn, registered nurse, RN, MDS, mds coordinator, rai, resident assessment coordinator.
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The Field Reimbursement Manager (FRM) will support physicians and their reimbursement staff, in working with patient reimbursement for buy-n-bill models and specialty pharmacy distributed products.
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All reimbursement activities are required to be conducted and managed within all appropriate legal and regulatory guidelines and require continuous monitoring of compliance with such guidelines and laws.
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reimbursement job Title: licensed practical nurse Company: Hca Healthcare
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