Senior Field Reimbursement Specialist

Overview

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.

Apply today!

• Under general supervision of a Senior Manager, the Sr Field Reimbursement Specialist (Regional FRM Lead) will plan and engage with customers, educate on access and reimbursement topics relevant to assigned client product, track progress and evaluate results of activities, and lead or direct more complex projects or aspects of projects.
• Operate with reasonable latitude for un-reviewed action or decision, requiring minimum correction on final review of work product. Work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide education through a focused effort on healthcare providers in community, institutional, and academic medical settings.
• Manage daily activities that support appropriate patient access to our client2;s products in provider offices and healthcare institutions, acting as a liaison to other patient assistance and reimbursement support services offered by our clients. The scope and approach are defined by the client2;s legal and compliance departments and may vary.
• Activities may include, but are not limited to:

• Review patient insurance benefit options with appropriate authorizations
• Validate prior authorization requirements
• Understanding of Specialty Pharmacy processes
• Educate provider office staff and practice managers on coordination needed to support client product, including infrastructure for in-office administration (buy and bill and monitoring of product) and updates on coverage and payer policy changes within assigned territories
• Educate provider office staff on payer coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeals processes
• Identify alternate funding/financial assistance programs
• Act as SME about coverage, specific product codes, including patient-specific access questions
• Effective account management: uncovering customer insights through questioning, critical thinking and problem solving; disseminating data and information to partners
• Review appropriate billing and coding for products
• Probe to understand office processes and root causes of access or reimbursement issues
• Drive resolution of reimbursement issues through an educational approach
• Collaborate with client patient services program representatives
• Educate physician office staff on the use of client patient assistance and support line reimbursement services, including web-based provider programs
• Deliver interactive educational presentations at various provider sites of service
• Provide information on relevant reimbursement topics related to client products based on client approval
• Communicate and collaborate with client cross-functional teams to include sales representatives, account managers and district managers
• Prioritize activities and adhere to processes to maximize coverage of accounts and track progress while following policies, procedures, and performance metrics
• Leverage reimbursement knowledge and resources to aid accounts and build customer partnerships
• Lead internal team training and meetings
• Serve as a peer buddy and mentor to colleagues
• Lead geography support for team members and manager
• Develop and execute business plan for assigned territory
• Performs other related duties as assigned

Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support. Experience with in healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred.

• Bachelor's degree preferred.
• Minimum of 7 years of experience
• Candidates must possess a Prior Authorization Certification…