Specialist - Field Reimbursement

Cencora, Inc.; Georgia; Sur place; USD 70 000 - 115 000; Plein temps

Résumé du poste

Cencora, Inc. is seeking a Field Reimbursement Specialist to educate provider office staff on logistics to support in-office administration, including buy-and-bill workflows and payer policy changes within assigned territories.

The role requires travel up to 80% weekly within the territory, educating on coverage strategies, coding, billing, prior authorization, and appeals, and serving as a liaison to patient assistance and reimbursement services to help patients access therapies.

Qualifications

• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners.
• 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.
• High School Diploma or GED required.
• Bachelor's degree or specific Practice Management experience preferred.
• Project management skills.
• Experience with extensive travel.
• Bilingual (desirable but essential).

Responsabilités

• Educate provider office staff and practice managers on logistics needed to support client product, including in-office administration workflows and payer policy changes within territories.
• Educate provider office staff on payer coverage strategies 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 reimbursement topics based on client approval.
• Perform other duties as assigned.

Connaissances

Field-based reimbursement

Education

Consultation

Cross-functional collaboration

Formation

High School Diploma or GED

Bachelor's degree or Practice Management experience

Description du poste

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. Job Details

The territories for this role are: North Carolina, South Carolina, Georgia

Interested candidates must reside within the listed territory and will be required to travel up to 80% within the specified area, including overnight trips.

Play a vital role in helping patients gain access to life changing therapies! From oral medications to biosimilars to critical cancer treatments to infusions, 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 assigned client’s product. The FRS will manage daily activities that support appropriate patient access to our client’s products in the provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Our teams travel weekly, sometimes requiring overnight travel, to healthcare offices within a designated territory, using their knowledge of coverage, patient assistance, and health policy to educate office staff and break through access issues to ultimately help patients.

As an FRS, a typical day might include:

• Educate provider office staff and practice managers on logistics needed to support client product, including infrastructure needed to support in-office administration including buy and bill and monitoring of product, and important coverage and payer policy changes within assigned territories.
• Educate provider office staff with understanding the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes.
• Probe to understand office processes and ability to discern 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’s approval
• Perform other duties as assigned

Requirements:

• 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.

Nice to have:

• High School Diploma or GED required
• Bachelor's degree or specific Practice Management experience preferred.
• Project management skills
• Experience with extensive travel
• Bilingual (desirable but essential)

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. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit

Full time

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 membership in 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. Therefore, 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 or email . 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