Field Reimbursement Manager: Elevate Patient Access

Valeris; Arizona; On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

Telehealth and EAP services

Company match on Health Savings/FSAs

Short-Term Disability with option for/

401(k) with 100% match

Paid Time Off and holidays

Inclusive workplace and diversity

Career advancement opportunities

Job summary

Valeris is seeking a Field Reimbursement Manager to help eliminate barriers for patients and educate providers on billing and coding for client products. You will resolve access issues, work with HUB and payer teams, and lead reimbursement education across sites of care.

Ideal candidates have experience with Prior Authorizations, reimbursement processes, and knowledge of Medicare/Medicaid. Travel up to 10% and collaboration with sales teams are expected.

Qualifications

• Associate's degree or higher in a related field or equivalent market experience.
• Working with specialty products, hubs, payers 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.
• 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.
• Educate HCP and Office Staff on Patient Support Programs and reimbursement rules.
• Lead onsite education of program business rules, payer coverage including review of J-codes and reimbursement activities.
• Manage daily activities that support patient access to client’s products across sites of care.
• Review billing and coding for products, assist with resolving reimbursement issues, and educate to avoid hurdles.
• Coordinate with client’s patient support services representatives on patient cases and claim issues.
• Educate office staff on use of client’s patient assistance and reimbursement tools and topics.
• Conduct policy surveillance across regional payers to ensure appropriate coding, coverage, and payment.
• Assist providers with understanding local payer coverage and reimbursement trends via educational sessions.
• Lead sales training related to product reimbursement as appropriate.
• Communicate reimbursement concerns with internal stakeholders, including Sales and Managed Markets.
• Work with Managed Markets to elevate potential payer issues.
• Adhere to training deadlines for corporate policies and confidentiality.

Skills

Payer policy

Billing & coding

Prior Authorization

Medicare & Medicaid

Field reimbursement

Specialty products

Hub programs

Education delivery

Education

Associate's degree or higher in a related field

Job description

Valeris is seeking a Field Reimbursement Manager to help eliminate barriers for patients and educate providers on billing and coding for client products. You will resolve access issues, work with HUB and payer teams, and lead reimbursement education across sites of care.

Ideal candidates have experience with Prior Authorizations, reimbursement processes, and knowledge of Medicare/Medicaid. Travel up to 10% and collaboration with sales teams are expected.