Field Reimbursement Lead: Patient Access & PA Expert

Valeris; Columbus (OH); Hybrid; USD 75,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

401(k) Retirement Savings Plan with 75

Paid Time Off and holidays

Job summary

Valeris is seeking a Field Reimbursement Manager (FRM) to join their team. The role supports patient access to therapies by educating offices on billing, coding, and reimbursement processes, including prior authorizations and appeals.

Travel up to 10% to support national programs and regional payers is required. Qualified candidates will have 3+ years in pharma/healthcare, direct payer policy knowledge, and strong stakeholder engagement.

Qualifications

• Associate's degree or higher in a related field or equivalent market experience
• 3+ in Pharma/Healthcare industry; 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.
• Knowledge of commercial payer, Medicare and Medicaid structure, systems, and reimbursement process.
• Demonstrated ability to conduct virtual and field-based reimbursement support and education.

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.
• Educate HCP and Office Staff on Patient Support Programs and reimbursement policies.
• Lead onsite education of program business rules, payer coverage and review of J-codes and other reimbursement activities.
• Guide providers through prior authorization and appeals process, documenting requirements and outcomes.
• Coordinate with patient support service representatives on patient cases and claim issues.
• Educate office staff on client patient assistance and reimbursement tools and programs.
• Educate on local payer coverage and reimbursement trends through educational programs.

Skills

Pharma/Healthcare

Stakeholder engagement

Education on reimbursement

Prior Authorization knowledge

Payer policy knowledge

Travel readiness

Job description

Valeris is seeking a Field Reimbursement Manager (FRM) to join their team. The role supports patient access to therapies by educating offices on billing, coding, and reimbursement processes, including prior authorizations and appeals.

Travel up to 10% to support national programs and regional payers is required. Qualified candidates will have 3+ years in pharma/healthcare, direct payer policy knowledge, and strong stakeholder engagement.