Key skills
CommunicationProblem SolvingPresentation SkillsAccount Management
About this role
Role Overview
- Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available
- Office interaction will include education and reimbursement support
- On-site/virtual interactions will average 15 per week
- Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams
- Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation
- Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs
- Responsible for setting up appointments and completing outbound calls to targeted offices
- Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information
- Monitor program performance for physicians and manufacturer representatives in accordance with expectations
- Research and compile provider / manufacturer representative specific information for reimbursement database
Requirements
- 4-year degree in related field or equivalent experience
- 4+ years of healthcare related reimbursement experience
- Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
- Experience supporting oncology products preferred
- Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
- Must have Medicare and commercial insurance coverage experience
- Proven presentation skills and experience
- Strong Computer literacy to include PowerPoint and Web Meeting experience
- Previous field experience, a plus
- Previous experience with specialty pharmacy a plus
- Account management experience, a plus
- Excellent Interpersonal skills
- Excellent written and oral communication skills
- Problem solving and decision-making skills
Benefits
- competitive compensation package
- performance-based annual bonus
- long-term incentive opportunities