Field Reimbursement Manager — Accelerate Patient Access

Valeris; Kansas; Remoto; USD 65.000 - 95.000; Tempo integral

Benefícios oferecidos por esta vaga

Medical, dental, and vision plans

HSA/FSA options

401(k) with match

Paid Time Off

Holidays & floating holidays

Resumo da vaga

Valeris is seeking a Field Reimbursement Manager to join our team and help eliminate barriers for patients to access medications. You will educate healthcare offices on billing and coding, resolve access issues, and partner with sales, payer teams, and providers to develop reimbursement strategies across regional sites.

Travel up to 10% and HIPAA compliance are required. You will work with HUB and client teams to ensure proper reimbursement pathways and education across diverse sites of care.

Qualificações

• Associate's degree or higher in a related field or equivalent market experience.
• 3+ years in Pharma/Healthcare industry; working with specialty products, hubs, payers or related area.
• Preferred: direct experience with specialty dermatology products.
• 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 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.
• Strong stakeholder engagement and communication skills

Responsabilidades

• Solve patient access issues by working across the HUB, provider offices and client field team.
• Partner with client’s Sales Team, Payer Teams, Marketing, HCPs, and their Specialty Pharmacies to create reimbursement strategies to increase access to therapy.
• Educate HCP and Office Staff on Patient Support Programs and reimbursement policies.
• Onsite education of program business rules and payer coverage including review of J-codes and related activities.
• Guide healthcare providers through the prior authorization and appeals process with required documentation.
• Manage daily activities supporting patient access across sites of care as an extension of HUB services.
• Review billing and coding for products and help resolve reimbursement issues.
• Coordinate with patient support representatives on cases and claims.
• Educate office staff on client’s patient assistance and reimbursement tools and topics.
• Monitor payer trends and ensure appropriate coding, coverage, and payment.
• Lead trainings on product reimbursement for relevant staff.
• Communicate reimbursement concerns with Sales and Managed Markets.
• Operate in HIPAA-compliant manner and meet training deadlines.
• Follow SOPs and BRDs consistently.

Conhecimentos

Prior Authorization experience

Billing & coding knowledge

Payer policy knowledge

Virtual & field reimbursement support

Communication skills

Formação

Associate's degree or higher in related field

Ferramentas

Hub systems

Payer databases

Descrição da vaga

Valeris is seeking a Field Reimbursement Manager to join our team and help eliminate barriers for patients to access medications. You will educate healthcare offices on billing and coding, resolve access issues, and partner with sales, payer teams, and providers to develop reimbursement strategies across regional sites.

Travel up to 10% and HIPAA compliance are required. You will work with HUB and client teams to ensure proper reimbursement pathways and education across diverse sites of care.