Strategic Access & Reimbursement Specialist

BioSpace; North Chicago (IL); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Benefits package

Short-term incentive programs

401(k)

Job summary

AbbVie in North Chicago is seeking a skilled access specialist to partner with Field Reimbursement Managers and Health Care Providers to optimize patient outcomes. You will manage prior authorization, medical exception, and appeal processes, educate on payer requirements, and help reduce access barriers for patients.

The role requires strong communication, deep knowledge of reimbursement, and the ability to navigate complex plans across territories while adhering to all regulations and privacy

Qualifications

• 3-5 years of experience in the healthcare industry with knowledge in reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations.
• Strong professional written and verbal communication skills to interact with all levels of the organization.
• Understanding of payer policies, coverage rules, and compliance requirements.

Responsibilities

• Collaborate with Field Reimbursement Managers (FRMs) and Health Care Providers (HCPs) in designated territories to enhance patient access and support positive health outcomes.
• Educate FRMs and HCPs on patient support programs, including tools and services for access and reimbursement. Inform them about resources available to resolve patient access challenges.
• Provide local expertise on plans and efficiently educate on all aspects of prior authorization, medical exception, and appeal processes within assigned region for all inbound and outbound calls.
• Develop and sustain relationships with relevant providers within the territory. Utilize strong communication skills to facilitate clear, concise, and efficient information exchanges with FRMs, HCPs, and other stakeholders.
• Take ownership of process improvement initiatives, continuously seeking ways to enhance system efficiencies and patient access strategies.
• Maintain an understanding of current business procedures, deviations, and case processing for all brands and channel sources, as needed.
• Utilize critical thinking to assess and prioritize workloads at the account level, ensuring optimal resource allocation and seamless operations.
• Monitor and streamline communication and interactions between stakeholders to promote efficiency and reduce redundancies.
• Meet or exceed department standards relative to performance metrics. Maintain a work environment that upholds privacy standards required by law and AbbVie policy. Understand and comply with all required training, including adherence to federal, state, and local laws, SPII policies and guidelines, and the policies and procedures of Complete Patient Access and AbbVie. Perform additional tasks, activities, and projects as deemed necessary by management.

Skills

Communication skills

Healthcare industry experience

Education

Bachelor's or Associate Degree in health sciences or business

Job description

AbbVie in North Chicago is seeking a skilled access specialist to partner with Field Reimbursement Managers and Health Care Providers to optimize patient outcomes. You will manage prior authorization, medical exception, and appeal processes, educate on payer requirements, and help reduce access barriers for patients.

The role requires strong communication, deep knowledge of reimbursement, and the ability to navigate complex plans across territories while adhering to all regulations and privacy