Field Reimbursement Manager

Coherus BioSciences; Town of Texas (AR, WI); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading biotech company is seeking a Field Reimbursement Manager to minimize access and reimbursement barriers for patients in the South Central region. The role involves addressing complex access issues and providing education on reimbursement programs. The ideal candidate has over 5 years of experience in the pharmaceutical industry and strong knowledge of healthcare policies and billing procedures.

Qualifications

• 5+ years of commercial experience in the pharmaceutical or biotech industry.
• 3+ years of experience in healthcare coverage, coding, and/or reimbursement.
• Direct experience with Buy and Bill products, Medicare Part B, and Miscellaneous J-Codes.

Responsibilities

• Address patient and practice reimbursement issues.
• Collaborate with Field Sales on education and support.
• Provide coding and reimbursement information to staff.

Skills

Experience with billing and medical claims

Expertise in coding and billing

Knowledge of Medicare and Medicaid

Familiarity with CPT, HCPCS, ICD-10

Ability to analyze healthcare policies

Education

Bachelor's degree from a four-year college or university

Job description

Title : Field Reimbursement Manager

Reports To : Director, Field Reimbursement Managers

Location : Field-based in the South Central - CO, NM, TX, OK, AR, MS, LA

Classification : Exempt

Position Summary :

The Field Reimbursement Manager (FRM) helps minimize access & reimbursement barriers for patients and providers to optimize access to Coherus’ Oncology & Retina product portfolio. Within their geography, the FRM is responsible for addressing access barriers by strategically working with customers and accounts to solve complex patient access issues through all facets of the reimbursement cycle. The FRM proactively provides education and support on Coherus reimbursement support programs (Coherus Solutions) to practices, facilities, and their staff.

As a member of the front-line field team, they serve as the key contact responsible for reimbursement and access support-related matters. The FRM will provide education and support the integration of account implementation plans for Coherus products within practices and sites of care. Additionally, the FRM will analyze reimbursement and access issues and act as the local access and reimbursement resource for internal Coherus partners in their assigned geography. The FRM will coordinate cross-functionally across Corporate Accounts, Patient Services, and Field Sales to support patient drug accessibility.

Key responsibilities include :

• Partner with internal and external stakeholders to identify, anticipate, and address patient and practice reimbursement issues.
• Collaborate with Field Sales to identify facilities and practices that need reimbursement education and support regarding Coherus products.
• Provide insights and updates regarding product and support service integration at accounts.
• Educate facility staff on policies related to product acquisition, inventory management, and payer policies to support full integration of the product into the practice workflow.
• Provide coverage, coding, and reimbursement information to key staff members (e.g., practice administrators, reimbursement staff, providers) to support patient access.
• Collaborate with field-facing “One Team” to share insights into customer needs, potential barriers, and payer issues/opportunities for access at practices.
• Communicate and explain payer policy updates or system changes that impact access.
• Proactively communicate Coherus COMPLETE to ensure office staff are fluent in using patient access programs and services.
• Address questions related to patient coverage, access, and reimbursement from accounts in collaboration with patient services as per policy and procedure.
• Conduct frequent claim reviews with practices to ensure appropriate reimbursement of Coherus products.
• Maintain a deep understanding of Coherus policies and requirements, performing roles in a compliant manner per company guidance.
• Stay informed about customer and market access industry trends.

Experience :

• 5+ years of commercial experience in the pharmaceutical or biotech industry.
• 3+ years of experience in healthcare coverage, coding, and/or reimbursement.
• Direct experience with Buy and Bill products, Medicare Part B, and Miscellaneous J-Codes required.
• Retina and/or Oncology experience strongly preferred.
• Bachelor's degree from a four-year college or university.

Skills, Knowledge & Abilities :

• Experience working with billing and medical claims personnel in various healthcare settings, including physician offices, hospitals, HOPDs, and ASCs.
• Expertise in supporting healthcare provider offices with coding, billing, and submissions across payer environments.
• Knowledge of Medicare, Medicaid, and other payer initiatives.
• Familiarity with CPT, HCPCS, ICD-10 revenue codes.
• Understanding of health insurance claim forms, explanation of benefits, prior authorization forms, and EMR/Practice Management systems to troubleshoot billing or documentation errors.
• Ability to analyze and interpret regulatory and legislative payer and healthcare policies.

Travel Requirements :

• Candidate must reside within the assigned territory and be able to travel up to 70%.

The Base Salary Range for this position is $, to $,. Coherus considers various factors, including professional background and work experience, when determining base pay. Actual compensation will vary.

Coherus provides equal employment opportunities to all employees and applicants, prohibiting unlawful discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by law. We also prohibit discrimination based on perceptions or association with individuals with these characteristics.

Beginning July 19, , all new hires must be fully vaccinated against COVID-19 as a condition of employment at Coherus BioSciences. If unable due to disability, medical condition, or sincerely held religious beliefs, a reasonable accommodation may be requested.