Field Reimbursement Specialist
Core
Field Reimbursement Specialist acts as a subject-matter expert ensuring patients can access specialty medications by educating healthcare providers on complex insurance and reimbursement processes.
Role type
Field Reimbursement Specialist
Builds
Patient access to specialty medications via provider education and reimbursement resolution
Domain
Healthcare / Specialty Pharmacy / Pharmacy Benefit Management
Deliverable
client delivery
Required skills
Specialty pharmacy dynamics, Revenue cycle management, Formulary analysis, Benefit investigations, Prior authorization processes, Coding and billing, Appeals processes, Pharmacy benefit policies
Preferred skills
Practice management experience, Field Reimbursement Manager experience, Direct healthcare access resolution experience
Technologies
Microsoft Word, PowerPoint, Excel, Outlook
Responsibilities
Educate provider office staff on payer coverage strategies, coding, billing, and appeal processes; Resolve reimbursement and coverage challenges to support patient access; Deliver interactive educational presentations at provider sites; Investigate root causes of access or reimbursement issues.
Seniority
Individual Contributor