Field Reimbursement & Access Strategist

Valeris; Iowa City (IA); Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

HSAs/FSAs

Telehealth support

401(k) with company match

Paid time off

9 holidays + 2 floating

Job summary

Valeris is seeking a Field Reimbursement Manager (FRM) to help expand patient access to therapies. You will educate providers on billing, coding, and patient support programs across multiple sites of care and collaborate with sales, payer, and managed markets teams to address payer barriers.

The role requires strong knowledge of medical benefit verifications, prior authorizations, and education delivery in virtual and field settings, with up-to-date understanding of commercial, Medicare, and

Qualifications

• Associate's degree or higher in a related field or equivalent market experience.
• Working with specialty products, hubs, payers, HCP or related area.
• Must have specific practice management, billing and/or coding experience for drugs, biologicals, or devices.
• Must have general payer policy knowledge including public and private payers, foundational knowledge of medical benefit verifications and prior authorization/pre-determination requirements and knowledge of reimbursement processes within various sites of care.
• Demonstrated ability to conduct virtual and field-based reimbursement support and education.
• Experience with Prior Authorizations, reimbursement billing, coding, and appeals process.
• Knowledge of commercial payer, Medicare and Medicaid structure, systems, and reimbursement process.

Responsibilities

• Solve complex patient access issues by working across the Hub, provider offices and communicating with client field team.
• Partner with client’s Sales Team, Payer Teams, Marketing, HCPs, and their Specialty Pharmacies to create and drive strategic reimbursement support approaches, resulting in increased access to therapy for individual patients.
• Educate HCP and Office Staff on Patient Support Programs, per program specific operating policies and patient journey.
• On occasion, lead HCP offices in onsite education of program business rules, payer coverage including review of miscellaneous J-codes, and other reimbursement related activities.
• The FRM will manage daily activities that support appropriate patient access to client’s products across relevant sites of care to work as an extension of the HUB reimbursement support services offered to providers.
• Review appropriate billing and coding for products, assist with resolving reimbursement issues, and help ensure appropriate education to avoid future reimbursement hurdles.
• Coordinate with client’s patient support services programs representatives on patient cases and claim issues.
• Educate office staff on the use of client’s 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 client’s products.
• Conduct policy surveillance across regional payers to ensure appropriate coding, coverage, and payment of client’s products.
• Assist providers with understanding local payer coverage and reimbursement trends through educational breakfast, lunch, and dinner programs.
• Lead sales training related to product reimbursement, as appropriate.
• Communicate reimbursement concerns and issues with appropriate internal stakeholders, including Sales and Managed Markets.
• Work collaboratively with Managed Markets team to elevate potential payer issues.
• On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data

Skills

Reimbursement exp.

Prior Authorization

Education & training

Virtual & field support

Payer policy knowledge

Education

Associate degree or higher

Tools

Billing systems

Coding knowledge

Medicare/Medicaid knowledge

Job description

Valeris is seeking a Field Reimbursement Manager (FRM) to help expand patient access to therapies. You will educate providers on billing, coding, and patient support programs across multiple sites of care and collaborate with sales, payer, and managed markets teams to address payer barriers.

The role requires strong knowledge of medical benefit verifications, prior authorizations, and education delivery in virtual and field settings, with up-to-date understanding of commercial, Medicare, and