Field Reimbursement Specialist

Cencora, Inc.; New Jersey; On-site; USD 70,000 - 100,000; Full time

Job summary

Cencora is seeking a Field Reimbursement Specialist to play a crucial role in helping patients access life-changing therapies. This position involves educating healthcare providers on reimbursement processes and supporting patient access while traveling within a designated territory. The ideal candidate will have experience in revenue cycles and a strong understanding of healthcare policies.

Benefits

Medical, dental, and vision care

Comprehensive wellness programs

Paid parental and caregiver leave

Professional development resources

Qualifications

• Experience in billing, prior authorization, and appeals processes.
• Understanding of medical/pharmacy benefits and policies.
• Ability to travel and perform educational presentations.

Responsibilities

• Educate provider staff on reimbursement issues and coverage strategies.
• Probing to understand and resolve access issues.
• Conduct field-based consultations to support key account customers.

Skills

Revenue cycle management

Patient assistance knowledge

Healthcare policy understanding

Education

High School Diploma/GED

Bachelor's degree in related field

Job description

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

Job Details

Play a vital role in helping patients gain access to life-changing therapies! From oral medications to biosimilars to critical cancer treatments, our associates, with their passion for patients, represent these therapies, providing education, coverage, and access solutions to healthcare personnel.

Field Reimbursement Specialists (FRSs) will plan and engage with customers, leveraging client-approved resources, to educate on access and reimbursement topics relevant to the assigned client’s product. The FRS will manage daily activities that support appropriate patient access to our client’s products in provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Our teams travel weekly, which could include overnight stays, to healthcare offices within a designated territory, using their knowledge of coverage, patient assistance, and health policy to educate office staff and address access issues to ultimately help patients.

As an FRS, a typical day might include:

• Educating provider office staff and practice managers on logistics needed to support the client’s product, including infrastructure for in-office administration, buy and bill, and monitoring of the product, as well as important coverage and payer policy changes within the territory.
• Educating provider office staff on payers’ coverage management strategies, including coding, billing, formulary, prior authorization, and appeals processes.
• Probing to understand office processes and root causes of access or reimbursement issues.
• Delivering interactive educational presentations at various provider sites.
• Providing information on relevant reimbursement topics related to our client’s products based on client approval.
• Performing other related duties as assigned.

Additional responsibilities include conducting field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners. Understanding the dynamics of Specialty Pharmacy vs. Specialty Distribution and the physician buy-and-bill model versus benefits assignment to alternate sites of care are essential. Candidates should have experience in revenue cycle management, buy and bill processes (including billing with miscellaneous J-codes), formulary, benefit investigations, prior authorization, coding, and appeals. A deep understanding of medical and pharmacy benefits/policies is required. Candidates must live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that may include Pennsylvania and New Jersey.

Nice to have qualifications include a High School Diploma/GED, a Bachelor's degree or specific Practice Management experience, project management skills, and extensive travel experience.

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. Our offerings include traditional medical, dental, and vision care, along with comprehensive wellness programs supporting physical, emotional, financial, and social health. This includes support for working families, backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. We also offer various training programs, professional development resources, mentorship opportunities, employee resource groups, volunteer activities, and more. For details, visit https://www.virtualfairhub.com/cencora.

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity regardless of race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status, or membership in any other protected class. We ensure all recruiting, training, compensation, benefits, promotions, and transfers are non-discriminatory. We provide reasonable accommodations for individuals with disabilities during the employment process. To request accommodations, contact us at 888.692.2272 or [e-mail]. Messages or emails unrelated to accommodation requests will not be responded to.

Affiliated Companies

Affiliated Companies: Cencora Patient Services, LLC