Field Reimbursement Specialist

Cencora; Wisconsin; Hybrid; USD 88,000 - 127,000; Full time

Job summary

A healthcare solutions company is seeking a Field Reimbursement Specialist to support patient access to products by educating healthcare providers on reimbursement processes. This role is vital for ensuring patients gain access to life-changing therapies. The candidate needs a high school diploma, with preference for a Bachelor’s degree or equivalent experience. A willingness to travel within a designated territory in the Midwest is essential. Competitive compensation and a comprehensive benefits package offered.

Benefits

Medical, dental, and vision care

Paid parental and caregiver leave

Professional development resources

Qualifications

• Ability to educate healthcare providers on reimbursement topics.
• Experience with billing, coding, and prior authorization processes.
• Must travel within a designated territory including multiple states.

Responsibilities

• Provide field support for patient access to products.
• Educate provider staff on logistics needed for patient support.
• Conduct educational presentations at provider sites.

Skills

Field-based reimbursement support

Specialty pharmacy knowledge

Revenue cycle understanding

Medical and pharmacy benefit knowledge

Education

High School Diploma/GED

Bachelor’s degree or Practice Management experience

Job description

Overview

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 delivering 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!

Responsibilities

• Field Reimbursement Specialists (FRSs) are responsible for providing field support for patient access to client’s specified products through interaction with the client’s patient support program and provider customers.
• FRSs provide their expertise and advanced skills to resolve complex patient access and provider reimbursement issues and to provide educational services across a variety of healthcare provider sites of care.
• FRSs work directly with the provider and their office support staff and commonly interact with other reimbursement and patient support services provided by clients.
• Play a vital role in helping patients gain access to life changing therapies. From oral medications to biosimilars to critical cancer treatments, our associates educate, provide coverage information, and offer access solutions to healthcare personnel.
• FRSs plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to the assigned client’s product. They manage daily activities that support appropriate patient access to the client’s products in provider offices and work as a liaison to other patient assistance and reimbursement support services offered by clients.
• Our teams travel weekly, which could include overnight stays, to healthcare offices within a designated territory, using knowledge of coverage, patient assistance, and health policy to educate office staff and address access issues to help patients.
• As an FRS, a typical day might include educating provider office staff and practice managers on logistics needed to support the client product, including infrastructure needed to support in-office administration, buy and bill, monitoring of product, and important coverage and payer policy changes within assigned territories.
• Educate provider office staff on the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes.
• Probe to understand office processes and root causes of access or reimbursement issues.
• Deliver interactive educational presentations at various provider sites of service.
• Provide information on relevant reimbursement topics related to our client’s products based on client approval.
• Performs other related duties as assigned.

Skills and Abilities

• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
• Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution.
• Broad understanding of the physician buy-and-bill model vs. assignment of benefits to alternate sites of care.
• Experience in revenue cycle, buy and bill (including billing with miscellaneous J-code), formulary, benefit investigations, prior authorization, coding, and appeals processes.
• Deep understanding of medical and pharmacy benefits/policies.
• Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that includes but may not be limited to MN, WI, IA, MO, and NE.

Education and Experience

• High School Diploma/GED required.
• Bachelor’s degree or specific Practice Management experience preferred.
• Project management skills.
• Experience with extensive travel.

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. We offer medical, dental, and vision care, and a comprehensive suite of benefits focusing on physical, emotional, financial, and social wellness. 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 training programs, professional development resources, mentorship programs, employee resource groups, volunteer activities, and more.

Salary Range*: $88,700 - 126,940 depending on locale. State-specific variations may apply.

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or any other class protected by federal, state, or local law.

The company’s continued success depends on the full and effective utilization of qualified individuals. Harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email [e-mail]. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned.

Affiliated Companies: Cencora Patient Services, LLC