Field Reimbursement Specialist
Core
Field Reimbursement Specialist acts as a liaison between providers, manufacturers, pharmacies, and payers to navigate reimbursement challenges and ensure patient access to specialty medications.
Role type
Field Reimbursement Specialist
Builds
Patient access to specialty medications via education and resolution of coverage barriers
Domain
Healthcare / Specialty Pharmacy / Pharmacy Benefit Management
Deliverable
client delivery
Required skills
Pharmacy benefit reimbursement expertise, prior authorization processes, appeals processes, specialty pharmacy dynamics, revenue cycle management, formulary management, coding and billing knowledge, health policy understanding
Preferred skills
Practice management experience, Field Reimbursement Manager experience, direct healthcare experience resolving pharmacy benefit access issues
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 for patients; Deliver interactive educational presentations at provider sites; Investigate root causes of access or reimbursement issues
Seniority
Individual Contributor, Field Specialist