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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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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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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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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 Field Reimbursement Manager (FRM) proactively provides education and support on product access programs for physicians and their staff. Your ability to clear the way, extrapolate intricate details, attend to complex situations and serve as a trusted go-between make you a perfect fit for a Field Reimbursement Manager role at Syneos Health.
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Additionally, the FRM will analyze reimbursement and access issues and act as the local access and reimbursement resource for other field sales force personnel and region management. The FRM will educate and support the integration of the product into physician offices as well as provide support on reimbursement related processes and issues, as needed.
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They serve as the key contact responsible for reimbursement and access support-related matters for the product in the assigned geography. 2+ years field reimbursement experience preferably with specialty products.
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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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CPA, MHA or MBA. Experience with Medicare/Medicaid cost reporting 4 - 6 years as a Sr. Reimbursement Analyst or similar position(s). This position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching of reimbursement fundamentals and principals, review of work and setting daily priorities.
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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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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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Educate office staff and providers on the use of Bausch + Lomb patient assistance and reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant reimbursement topics related to Bausch + Lomb products.
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Support patient access assistance from prescriber decision through to fulfillment, supporting the entire Reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms.
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Must have general payer policy knowledge including public & private payers, foundational knowledge of benefit verifications & prior authorization/pre-determination requirements (including appeals/exceptions), & knowledge of access & reimbursement processes within various sites of care.
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reimbursement job Title: representative Company: Speedway Llc
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