Specialist, Access and Reimbursement
Core
Partner with Field Reimbursement Managers and Health Care Providers to optimize patient outcomes by managing prior authorization, medical exceptions, and appeals.
Role type
Specialist, Access and Reimbursement
Builds
Patient access strategies and reimbursement support tools
Domain
Healthcare / Specialty Pharmacy / Payer Policy
Deliverable
client delivery
Required skills
Prior authorization processes, medical exception handling, appeal processes, payer policy knowledge, specialty pharmacy operations, coverage and coding rules, account-level workload assessment, process improvement
Preferred skills
Health sciences or business degree, reimbursement and billing experience, billing and payment distribution knowledge
Technologies
Access and reimbursement support tools
Responsibilities
Educate FRMs and HCPs on patient support programs and access tools, handle inbound and outbound calls regarding payer processes, develop relationships with providers in assigned territories, lead process improvement initiatives, monitor stakeholder communication for efficiency, meet performance metrics
Seniority
Mid-level specialist