Specialist - Field Reimbursement
Core
Subject-matter expert ensuring patient access to specialty medications by educating healthcare providers on complex insurance and reimbursement processes.
Role type
Field Reimbursement Specialist
Builds
Patient access to specialty medications
Domain
Healthcare / Pharmacy Benefit Management
Deliverable
client delivery
Required skills
Pharmacy benefit reimbursement, prior authorizations, appeals, specialty pharmacy operations, revenue cycle management, formulary analysis, coding and billing, payer policy navigation
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 insurance issues, payer coverage strategies, coding, billing, formulary, prior authorization, and appeal processes; Resolve reimbursement and coverage challenges; Deliver interactive educational presentations at provider sites; Investigate root causes of access or reimbursement issues.
Seniority
Individual Contributor, Specialist level