Virtual Field Reimbursement Specialist
- 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 access support services offered by our clients (i.e. HUB, Call Center, Specialty Pharmacy Services)
- Act as an extension of the call center and/or HUB and provide live one-on-one coverage support
- Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner
- Offer office education during the entire access process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution
- Educate offices using approved materials provided by the client
- Review patient-specific information in reimbursement cases where the office has specifically requested assistance in resolving access issue or coverage challenge
- Educate physician office staff on the use of our client’s patient support services, including web based provider portals
- Bachelor’s Degree
- Minimum two years of experience in public or private third party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
- Experience with specialty/biologic or physician administered products
- Demonstrated ability to educate offices on access processes – including but not limited to:
- Experience educating HCPs on client specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.)
- Experience delivering educational presentations
- Advanced knowledge of medical insurance terminology
- Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D
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