Hybrid Field Reimbursement Manager
Listed on 2026-02-03
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Healthcare
Healthcare Administration, Healthcare Management
Overview
Updated: January 29, 2026
Location: Dallas, TX, United States
Job : 13771-OTHLOC-C0swYfwG
You are an expert facilitator: you open doors, foster communication, and bridge the gap.
The Virtual Field Reimbursement Manager (VFRM) will be responsible for the management of defined accounts in a specified geography. The VFRM will execute a strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. In this role, the VFRM will serve as a reimbursement subject matter expert and will be responsible for providing office education during the entire process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution.
CoreResponsibilities
- Serves as the primary virtual reimbursement contact for assigned accounts, responding to reimbursement requests
- Serves as payer expert and interpret and communicate payer changes, payer policies for Medicare, Medicaid and Commercial plans to key stakeholders in a timely manner
- Provides education and support to prescribing physicians and support staff regarding reimbursement, coding and patient access issues
- Benefit verification results
- Prior authorization requirements
- Appeals processes
- Claims submission and denial troubleshooting
- Site of Care considerations (Buy and Bill)
- CPT, HCPCS/J-codes, ICD-10, diagnosis of codes
- Assists with claims issue resolution, including underpayments, denials, and requests for additional documentation
- Tracks payer-specific challenges and communicate access or time-to-therapy trends, while triaging complex reimbursement or policy issues to appropriate internal partners for escalation when needed
- Maintains detailed documentation of reimbursement cases, trends, and outcomes to identify recurring access barriers
- Manages multiple reimbursement cases simultaneously while meeting service-level expectations
- Coordinate virtually and in-person as needed with internal partners to:
- Share payer insights and recurring reimbursement challenges
- Support consistent messaging related to access pathways
- Provide clear, timely updates on case status and resolution outcomes using approved internal tools and processes
- Participate in internal meetings and trainings to stay aligned on reimbursement strategy and product updates
- 5+ years of pharmaceutical &/or biotech experience
- 1+ years of experience in field reimbursement
- Ability to solve access issues related in specialty pharmacy channel
- Experience in oncology nice to have, not required
- Ability to travel 15% – 80% virtual and 15% live
Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:
- 5+ years of pharmaceutical &/or biotech experience
- 1+ years of experience in field reimbursement
- Ability to solve access issues related in specialty pharmacy channel
- Experience in oncology is nice to have, not required
- Ability to travel 15% – 80% virtual and 15% live
Our ability to collaborate and problem-solve makes a difference in patients’ lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities.
Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients. Experience the thrill of knowing that your everyday efforts are contributing to improving patients’ lives around the world.
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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled).
Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local…
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