Field Reimbursement Manager

McKesson; Pennsylvania; Remote; USD 80,000 - 134,000; Full time

Job summary

McKesson in the United States is hiring an Education Specialist focused on reimbursement. You will deliver on-site and remote education to office staff, addressing Medicare and commercial coverage, prior authorizations, and benefit investigations.

You will run education sessions, report results, and collaborate with case managers to improve billing and coding processes. You will travel as needed and work within FRM CRM to document activities.

Qualifications

• 4-year degree in related field or equivalent experience.
• 4+ years of healthcare related reimbursement experience.
• Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
• Experience in insurance verification, prior authorizations, and/or claim adjudication.
• Medicare and commercial insurance coverage experience.
• Proven presentation skills and ability to manage multiple priorities.
• Strong computer literacy including PowerPoint and Web Meeting.

Responsibilities

• Provide on-site and on-demand education for the office staff on reimbursement challenges.
• Educate on Benefit Investigation, Prior Authorization, Support Center Services, Medicare and Commercial coverage and patient communication streams.
• Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance.
• Set up appointments and complete outbound calls to targeted offices; interface with physicians and manufacturer representatives; document FRM CRM activities.
• Monitor program performance for physicians and manufacturer representatives; use FRM CRM dashboard; report quarterly to client.

Skills

Healthcare reimbursement experience

Presentation skills

Organizational skills

PowerPoint/Web Meeting experience

Education

4-year degree in related field or equivalent experience

Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

Key Responsibilities

• Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include education and reimbursement support. On-site/virtual interactions will average 15 per week. These activities are recorded in FRM CRM daily with reporting to manager weekly.
• Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly to client.
• Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs. FRM will collaborate with case manager on average of 4/month and ad hoc as needed for escalations. These interactions are tracked in FRM CRM and hub system.
• Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information. All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client.
• Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting. Additionally, clients have the option to survey customers on program performance.
• Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles) FRM will create a facility database on each new provider in FRM CRM. All interactions/activities are built utilizing this database.

Minimum Job Qualifications

• 4-year degree in related field or equivalent experience
• 4+ years of healthcare related reimbursement experience

Business Experience

• Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
• Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
• Must have Medicare and commercial insurance coverage experience.
• Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis.
• Proven presentation skills and experience
• Proven ability to effectively handle multiple priorities and excellent organizational skills
• Strong Computer literacy to include PowerPoint and Web Meeting experience

Specialized Knowledge/Skills

• Previous field experience, a plus
• Previous experience with specialty pharmacy a plus
• Account management experience, a plus
• Excellent Interpersonal skills.
• Excellent written and oral communication skills
• Problem solving and decision-making skill

Working Conditions

General Office Demands – Remote, WFH

Travel Requirements

Must reside in territory

Must be able to travel 80% (4 days a week) via automobile or plane

Must have a valid driver's license with a clean driving record/ MVR

Physical Requirements (Lifting, Standing, Etc.)

Possible long periods of sitting and/or keyboard work. General office demands.

Our Base Pay Range for this position

$80,300 - $133,800

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) [e-mail] or (Canada) [e-mail]. Resumes or CVs submitted to this email box will not be accepted.

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