Field-Based Reimbursement & Access Specialist

Valeris; Oklahoma; On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

Telehealth services

HSA/FSA contributions

Company match on Health Savings Plan

Short-Term Disability coverage

401(k) with company match

Paid Time Off and holidays

Career advancement opportunities

Diversity and inclusive workplace

Job summary

Valeris is seeking a Field Reimbursement Manager (FRM) to join our team and help eliminate barriers to patient access by educating healthcare providers on appropriate billing, coding, and reimbursement strategies for our clients’ therapies. You will partner with Sales, Payer Teams, and HCPs to develop strategic reimbursement support and training across various sites of care.

The FRM will serve as the subject-matter expert on medical benefits reimbursement, prior authorizations, and appeals,

Qualifications

• Experience with medical benefit verifications and reimbursement processes across various sites of care.
• Ability to conduct virtual and field-based reimbursement support and education.
• Strong understanding of public and private payer structures (Medicare/Medicaid).

Responsibilities

• Solve complex patient access issues by coordinating with HUB, provider offices and client field team.
• Educate HCP offices on patient support programs and billing rules.
• Lead onsite education of program business rules and payer coverage; review J-codes.
• Manage daily activities to support patient access across care sites.
• Review billing/coding and assist in resolving reimbursement hurdles.
• Coordinate with patient support services representatives on cases and claims.
• Educate staff on patient assistance and reimbursement tools and websites.
• Conduct policy surveillance for payer coverage and payment adequacy.
• Lead reimbursement trainings for sales and Managed Markets teams.
• Communicate reimbursement concerns to internal stakeholders; collaborate with Managed Markets.
• Travel up to 10% for national meetings and trainings.

Skills

Reimbursement knowledge

Payer policies

Prior authorizations

Billing & coding

Virtual training

Communication skills

Education

Associate's degree or higher in a related field

Job description

Valeris is seeking a Field Reimbursement Manager (FRM) to join our team and help eliminate barriers to patient access by educating healthcare providers on appropriate billing, coding, and reimbursement strategies for our clients’ therapies. You will partner with Sales, Payer Teams, and HCPs to develop strategic reimbursement support and training across various sites of care.

The FRM will serve as the subject-matter expert on medical benefits reimbursement, prior authorizations, and appeals,