Sr Reimbursement Specialist/Manager (Field-Based/TX, GA, NC) – NC Pharma

Our client, a Raleigh area specialty pharmaceutical firm in high growth mode, is actively recruiting for a very sharp, knowledgeable and self-directed Reimbursement Specialist for key role on its Managed Markets team.

Company is undergoing tremendous expansion, including the recent acquisition and launch of several new products. Ensuring practitioners have quality and timely information about these products as well as payment practices and strategies is essential. This Field Reimbursement Manager will play a key role.

This is a field-based role that will require extensive travel including physician office visits, sales rep ride-alongs and new client training. Seek candidate who enjoys a home-based position and high travel (50-80%). Desirable home-based locations include Dallas and major cities in Georgia and North Carolina.

The focus of the role is to provide expertise to prescribers and support staff to help resolve patient access issues and to provide educational services within relevant sites of care.
Primary responsibilities include:
 acting as key liaison with physician and staff to support patient access to products
 reviewing patient benefit options, prior authorization requirements, and alternate financial assistance programs
 reviewing appropriate billing and coding for products; assisting with resolving reimbursement issues
 educating office staff on the use of company’s reimbursement support services
 participating in sales rep training related to product reimbursement

The ideal candidate will offer a related degree and 2+ years of directly-related experience including some bkgd in field-based reimbursement role with a pharmaceutical company (consulting firm bkgd desirable). Other priorities include:
 broad knowledge of the claims revenue cycle process and ability to assist prescribers in addressing barriers to patient access
 foundational knowledge of benefit verifications and prior authorization/pre-determination requirements
 practice management, billing and/or coding experience for drugs, biologicals or devices under a “buy and bill” and specialty pharmacy model
 understanding of reimbursement considerations from a patient and provider perspective
 experience with new product launches, including billing with a miscellaneous HCPCS code, miscellaneous CPT code, and/or transition to billing with a unique HCPCS code

In addition, seek a versatile and astute communicator and relationship-builder. This Field Reimbursement Manager is the face of the company and must bring exceptional professionalism and quality-orientation.

Company will pay excellent wage for excellent person. Company car and industry-leading benefits will be included.
Please forward Word resume for prompt consideration.