Reimbursement Business Manager-Ophthalmology-Nashville, TN

Regeneron Pharmaceuticals, Inc.; Tennessee; Remote; USD 166,000 - 210,000; Full time

Benefits offered by this job

Annual bonuses or incentive plans

Equity awards

Pension or retirement benefits

401(k) company match

Health and wellness programs

Fitness centers

Insurance benefits (medical, dental, V

Vision and disability

Paid time off

Family support benefits

Job summary

Regeneron Pharmaceuticals, Inc. seeks a Field Reimbursement Manager to support physician offices across reimbursement cycles and educate on CPT/HCPCS coding and payer requirements to sustain patient access.

This remote role covers the Nashville region with travel up to 70% and collaboration with Regeneron colleagues to align on coverage strategies and product access. We value compliant, proactive problem solving and strong communication with accounts.

Qualifications

• Bachelor's degree required; 5-8 years pharma/biotech/device experience with 3-5 years in healthcare coverage or reimbursement.
• Experience with billing and medical claims in diverse settings (physician offices, hospital, ASC, etc.).
• Strong CPT/HCPCS/ICD-10 knowledge; Medicare/Medicaid experience and payer initiatives.
• Familiarity with UB-04, CMS-1500, EOBs, prior authorization forms; regulatory payer policy analysis.
• Must reside in assigned territory and travel 50-70%.

Responsibilities

• Develop and execute account plans to build reimbursement confidence with MDs and staff; support patient access.
• Educate accounts on support services to ensure patient access and monitor impact of services.
• Collaborate with Regeneron colleagues to educate offices on coverage/coding and patient access.
• Guide providers in resolving reimbursement issues in line with Regeneron policies.
• Anticipate customer needs and market changes; manage FRM territory with proactive planning.
• Establish positive relationships with accounts and manage product concerns.
• Update customers on reimbursement requirements, payer trends, and payer policy changes.

Skills

Healthcare reimbursement experience

Billing and coding knowledge

Travel readiness

Education

Bachelor's degree

Tools

CPT/HCPCS/ICD-10 knowledge

Job description

Build Our Future Together

The Field Reimbursement Manager is a critical front-line member of the Regeneron Ophthalmology Field team. You will use your expertise and knowledge with all Regeneron customers, both internal and external. In this role, you will support physician offices throughout all facets of the reimbursement cycle and work to ensure the lines of communication remain open for existing and future Regeneron products. We always do what is right and seek to fully understand provider business drivers to help develop compliant approaches to account issues and management.

Build Our Future Together

The Field Reimbursement Manager is a critical front-line member of the Regeneron Ophthalmology Field team. You will use your expertise and knowledge with all Regeneron customers, both internal and external. In this role, you will support physician offices throughout all facets of the reimbursement cycle and work to ensure the lines of communication remain open for existing and future Regeneron products. We always do what is right and seek to fully understand provider business drivers to help develop compliant approaches to account issues and management.

When & Where

• Remote role
• Location: Nashville, TN

Discover Your Role

• Develop and execute account plans that build reimbursement confidence with customers (e.g. MD and staff) & support continued patient access.
• Proactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers.
• Develop collaborative relationships with Regeneron colleagues (ex. Regional Directors and Medical Specialists) to educate physician offices in coverage/coding of Regeneron products and support patient access to care.
• Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes.
• Anticipate and adapt to the customer’s needs, as well as market changes and challenges.
• Demonstrate proactive planning and time management skills by the efficient and effective coverage of your assigned FRM Territory.
• Establish positive working relationships with accounts (e.g. MD’s, Administrators & office staff) and effectively manage product concerns.
• Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize basket of company approved access materials to support reimbursement confidence.

This Role Requires

• Bachelor's degree from a four-year college or university.
• 5-8 years' pharmaceutical/biotech/device experience, including minimum of 3-5 years healthcare coverage, coding and/or reimbursement experience.
• Previous experience working with billing and medical claims personnel in various health care settings, including, but not limited to a physician office, hospital, HOPD or ASC.
• Shown expertise in supporting healthcare provider offices with coding, billing, and submissions in range of payer environments. Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives.
• We expect you to be familiar with CPT, HCPCS, ICD-10, revenue codes and DRG, coverage.
• Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur.
• Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies.
• Candidate must reside within assigned territory and have ability to travel 50%-70% of the time.

We are committed to building a workplace with an inclusive culture.

Regeneron is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion or belief (or lack thereof), sex, sexual orientation, gender identity or expression, gender reassignment, marital or civil partnership status, civil status, pregnancy or parental status, age, disability, nationality, citizenship status, ethnic or national origin, membership of the Traveler community, familial status, genetic information, military or veteran status, or any other characteristic protected under applicable law. Where required, we will provide reasonable accommodation to applicants with known disabilities or chronic illnesses during the recruitment process, unless such accommodation would impose undue hardship.

Where necessary, we disclose salary ranges for roles in all countries in which we operate. The final offer will be determined within the relevant range based on the country of employment, specific role level, and your skills and experience. In some countries, collective bargaining agreements (CBAs) may apply and influence certain elements of pay or benefits.

• annual bonuses or other incentive plans
• equity awards
• pension or retirement benefits
• 401(k) company match
• health and wellness programs
• fitness centers
• insurance benefits (e.g. medical, dental, vision, life and disability)
• paid time off
• family support benefits

For additional information about Regeneron benefits in the U.S., please visit https://careers.regeneron.com/en/working-at-regeneron/total-rewards/. For other locations, additional information will be provided during the recruitment process.

If you have any questions, please speak with your recruiter.

Please be advised that at Regeneron, we believe we do our best work when we are together. For that reason, many roles are required to be performed on-site. Please speak with your recruiter and hiring manager for more information about on-site expectations for your role and location.

As part of the recruitment process, certain background checks may be conducted in accordance with the laws of the country where the position is based. The purpose of such checks is to verify certain information prior to the commencement of employment such as identity, right to work and educational qualifications.

For jobs in Canada: this posting is for an existing position.

Salary Range (annually)

$165,600.00 - $209,600.00