Field Reimbursement & Access Specialist

Cencora; Massachusetts; Sur place; USD 95 000 - 148 000; Plein temps

Résumé du poste

Cencora is seeking a Field Reimbursement Specialist to educate provider offices on coverage, reimbursement and access strategies across a designated US territory. The role requires heavy travel to healthcare offices within New York, Massachusetts, Connecticut and adjacent areas, with a focus on improving patient access to therapies.

You will collaborate with payers, offices, and internal teams to explain buy-and-bill processes, coding and prior authorization workflows while supporting client

Qualifications

• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
• Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution.
• Broad understanding of physician buy-and-bill model vs. assignment of benefits to alternate sites of care.
• Experience in revenue cycle, buy and bill (including billing with miscellaneous J-code), formulary, benefit investigations, prior authorization, coding, and appeals processes.
• Deep understanding of medical and pharmacy benefits/policies.

Responsabilités

• Educate provider office staff and practice managers on logistics to support client product, including in-office administration and coverage changes.
• Explain payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization and appeals.
• Probe to understand office processes and root causes of access or reimbursement issues.
• Deliver interactive educational presentations at provider sites of service.
• Provide information on relevant reimbursement topics based on client approval.

Connaissances

Field-based reimbursement

Specialty Pharmacy knowledge

Revenue cycle understanding

Prior authorization knowledge

Coding and billing basics

Formation

High School Diploma or GED

Bachelor's degree

Description du poste

Cencora is seeking a Field Reimbursement Specialist to educate provider offices on coverage, reimbursement and access strategies across a designated US territory. The role requires heavy travel to healthcare offices within New York, Massachusetts, Connecticut and adjacent areas, with a focus on improving patient access to therapies.

You will collaborate with payers, offices, and internal teams to explain buy-and-bill processes, coding and prior authorization workflows while supporting client