Job Description
Description Responsibilities The Field Reimbursement Manager (FRM) will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting the clients product's. They will educate HCPs and their staff on matters related to access and coverage to facilitate appropriate patient access. The FRM will analyze reimbursement and access issues and act as the local access and reimbursement resource for other field sales force personnel and regional management. They will coordinate with the Hub concerning individual patient cases including patient support services referrals to enrollment, and overall coordination. The FRM will need to collaborate cross functionally with Field Sales as well as other matrix partners and Specialty Pharmacy Accounts while abiding by all corporate and industry policy and procedures.
- Analyze payer criteria
- Provide offices product access expertise
- Provide patient support services education to field teams etc.
- Coordinate on reimbursement issues with third parties including Hubs
- Liaise with Specialty Pharmacy for pharmacy benefit products
- Educate HCPs on reimbursement processes claims submissions, procedures and coding requirements of payer organizations (local payers, government payers, etc.)
- Provide information to HCP on how the products are covered under the benefit design (Commercial, Medicare Part D, Medicaid)
- Answer questions about coverage, ICD-10 codes of product, including patient-specific access questions
- Educate and update HCPs on key private and public payer coverage and changes that impact the products access for patients
- Support patient access to the products by providing subject matter expertise on access issues that may be barriers to product access in a manner that complies with policies, processes, and standard operating procedures
- Educate HCPs and their practice personnel on the products Hub program including reimbursement, financial assistance and Hub tools (e.g. provider portal tool, copay tracking, forms)
- Demonstrate knowledge of and communicate information about resources and forms available for access and reimbursement
- Demonstrate strong verbal communication skills and issue prioritization related to account management
Job Requirements Along with a results-oriented mindset, self-assurance and an engaging manner, the ideal candidate has: - BS/BA Degree required or 3+ years experience as a field reimbursement specialist or biologic coordinator/office practice manager
- Prior experience as a field reimbursement specialist required
- Experience navigating Prior Authorization process for pharmacy and medical benefit coverage
- Cardiology or Rare Disease preferred
- Proven experience with Hubs, in-depth knowledge on issues related to billing, coding, appeals across physician types
- Experience with commercial payers, Medicare plans and state Medicaid in geographic region
- Exhibit competent understanding of Hub activities
- Valid driver's license and the ability to travel, including overnights and/or weekends
At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn't align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.
Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients' lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients' lives around the world.
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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)
Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements. Syneos Health Careers
Job Tags
Local area, Flexible hours, Night shift,