Field Reimbursement Strategist - Patient Access Expert

Valeris; Sioux Center (IA); Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical, dental and vision plans

Company match on 401(k)

Paid time off and holidays

Inclusive culture and growth

Job summary

Valeris seeks a Field Reimbursement Manager to help remove barriers to patient access, educate providers on billing and coding, and work with HUB and patient support services across various sites of care.

The FRM will serve as an expert in medical benefit reimbursement, prior authorization, and appeals, collaborating with Sales, Managed Markets, and payer teams. Travel up to 10% is expected.

Qualifications

• Associate's degree or higher in a related field or equivalent market experience.
• 3+ years in Pharma/Healthcare industry with specialty products, hubs, payers, HCPs 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, medical benefit verifications and prior authorization requirements.
• Experience with Prior Authorizations, reimbursement billing, coding, and appeals process.

Responsibilities

• Solve patient access issues by coordinating with Hub, provider offices and client field team.
• Partner with Sales, Payer Teams, Marketing, HCPs, and Specialty Pharmacies to improve access to therapy.
• Educate HCPs and office staff on patient support programs and program rules.
• Lead onsite education of payer policies, codes, and reimbursement activities when needed.
• Guide providers through prior authorization and appeals, including documentation and payer requirements.
• Coordinate with patient support services on cases and claim issues and educate on provider programs.

Skills

Stakeholder engagement

Communication skills

Reimbursement knowledge

Prior Authorization experience

Payer policy knowledge

Education

Associate's degree or higher in a related field

3+ years in Pharma/Healthcare industry

Billing and coding experience for drugs/biologics/devices

Job description

Valeris seeks a Field Reimbursement Manager to help remove barriers to patient access, educate providers on billing and coding, and work with HUB and patient support services across various sites of care.

The FRM will serve as an expert in medical benefit reimbursement, prior authorization, and appeals, collaborating with Sales, Managed Markets, and payer teams. Travel up to 10% is expected.