Oncology Access & Reimbursement Lead

SmartRecruiters, Inc.; Hartford (CT); On-site; USD 132,000 - 238,000; Full time

Benefits offered by this job

Paid time off

Health insurance

401(k)

Job summary

AbbVie seeks a field-based reimbursement specialist to educate HCPs on patient support programs, access options, and payer policies across oncology. You will collaborate with internal stakeholders, monitor reimbursement trends, and establish provider relationships within your territory.

HCIR credentialing and physician-facing communications are essential. The role requires proximity to Albany, NY or nearby travel readiness.

Qualifications

• Oncology and/or hematology-oncology experience strongly preferred, including experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models.
• Demonstrated understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations.
• Strong understanding and ability to communicate technical elements of coding and billing requirements at the National and Regional level across all settings of care.
• Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics.
• An essential requirement of your position is to satisfy all applicable HCIR credentialing requirements to gain and maintain entry into facilities and organizations that are in your assigned territory.
• These HCIR credentialing requirements may include, but are not limited to, background checks, drug screens, proof of immunization/vaccination for various diseases, fingerprinting and specific licenses required by individual state or cities. Please remember that you are solely responsible for ensuring that you satisfy all HCIR credentialing requirements and for any associated liability for failing to do so. to AbbVie has resources to answer questions you may have regarding your responsibilities.
• Excellent territory and account management skills
• Valid driver’s license

Responsibilities

• Educate HCPs on patient support programs, including access and reimbursement support tools and services
• Educate on product-specific acquisition and access options such as specialty pharmacy networks, specialty distribution, and white-bagging support
• Educate on resources available to address access issues
• Provide local expertise in regards to national/regional payor policies in order to educate providers on payer issues, coding changes, and appropriate claims submission processes
• Collaborate with multiple Oncology internal stakeholders for key account management
• Report back payer trends related for approved products to Patient Services and MHC account management teams
• Establish and maintain relationships with appropriate providers within territory
• Remain current on key managed care, reimbursement, and policy activities

Skills

Oncology experience

Hematology-oncology experience

HCIR credentialing

Coding and billing knowledge

Payer policy knowledge

Territory management

Driver's license

Provider education

Job description

AbbVie seeks a field-based reimbursement specialist to educate HCPs on patient support programs, access options, and payer policies across oncology. You will collaborate with internal stakeholders, monitor reimbursement trends, and establish provider relationships within your territory.

HCIR credentialing and physician-facing communications are essential. The role requires proximity to Albany, NY or nearby travel readiness.