Overview
Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!
Responsibilities
Under general supervision of a Senior Manager, the Sr Field Reimbursement Specialist (Regional FRM Lead) will plan and engage with customers, educate on access and reimbursement topics relevant to assigned client product, track progress and evaluate results of activities, and lead or direct more complex projects or aspects of projects.
Operate with reasonable latitude for un-reviewed action or decision, requiring minimum correction on final review of work product. Work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide education through a focused effort on healthcare providers in community, institutional, and academic medical settings.
Manage daily activities that support appropriate patient access to our client2;s products in provider offices and healthcare institutions, acting as a liaison to other patient assistance and reimbursement support services offered by our clients. The scope and approach are defined by the client2;s legal and compliance departments and may vary.
Activities may include, but are not limited to:
Review patient insurance benefit options with appropriate authorizations
Validate prior authorization requirements
Understanding of Specialty Pharmacy processes
Educate provider office staff and practice managers on coordination needed to support client product, including infrastructure for in-office administration (buy and bill and monitoring of product) and updates on coverage and payer policy changes within assigned territories
Educate provider office staff on payer coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeals processes
Identify alternate funding/financial assistance programs
Act as SME about coverage, specific product codes, including patient-specific access questions
Effective account management: uncovering customer insights through questioning, critical thinking and problem solving; disseminating data and information to partners
Review appropriate billing and coding for products
Probe to understand office processes and root causes of access or reimbursement issues
Drive resolution of reimbursement issues through an educational approach
Collaborate with client patient services program representatives
Educate physician office staff on the use of client patient assistance and support line reimbursement services, including web-based provider programs
Deliver interactive educational presentations at various provider sites of service
Provide information on relevant reimbursement topics related to client products based on client approval
Communicate and collaborate with client cross-functional teams to include sales representatives, account managers and district managers
Prioritize activities and adhere to processes to maximize coverage of accounts and track progress while following policies, procedures, and performance metrics
Leverage reimbursement knowledge and resources to aid accounts and build customer partnerships
Lead internal team training and meetings
Serve as a peer buddy and mentor to colleagues
Lead geography support for team members and manager
Develop and execute business plan for assigned territory
Performs other related duties as assigned
Experience and Education Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support. Experience within healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred.
Bachelor's degree preferred.
Minimum of 7 years of experience
Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment.
Skills and Abilities
Ability to effectively manage multiple client relationships and customer interactions
Ability to manage and support external meetings, presentations, and client interactions
Ability to lead and work in a matrix environment
Proven teamwork and collaboration skills in highly matrixed and cross-functional organizations
Ability to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the role
Ability to work with client program vendors to deliver a positive customer experience
Sound judgment and decision-making ability with emotional intelligence
Creative problem-solving skills
Ability to manage competing priorities with a sense of urgency
Demonstrated territory and coordination management skills
Results oriented; excellent communication skills for presenting complex information
Ability to build and maintain relationships with business partners and healthcare professionals
Understanding of physician buy-and-bill vs. assignment of benefits to alternate sites of care
Deep understanding of medical and pharmacy benefits/policies
Understanding of Specialty Pharmacy vs. Specialty Distribution
Ability to educate on reimbursement and access issues to drive pull-through
Ability to conduct field-based reimbursement and access support, education, and consultation
Experience in revenue cycle, buy and bill, formulary, benefit investigations, prior authorization, coding, and appeals
Knowledge of private payer, Medicare, and Medicaid structures and policies
Understanding of patient support programs including financial and co-payment assistance
Strong listening and response skills
Team subject matter expertise and training delivery
Strong presentation skills, especially in small groups
Above-average computer skills: MS PowerPoint, MS Excel, MS Word, MS Outlook
What Cencora offers We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members9 ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we provide a comprehensive suite of benefits focusing on wellness across physical, emotional, financial, and social aspects. This includes support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. We offer training programs, professional development resources, mentorship opportunities, employee resource groups, and volunteer activities. For details, visit the following site: https://www.virtualfairhub.com/cencora
Salary Range Full time: $100,700 - 155,100. This salary range reflects a national average; actual range may vary by locale. State-specific locations may be up to 10% lower or 12% higher than the stated range in states including Colorado, California, Washington, New York, Hawaii, Vermont, Minnesota, Massachusetts, Illinois, and others.
Equal Employment Opportunity Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.
The company2;s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.
Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned.
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Affiliated Companies Affiliated Companies: Cencora Patient Services, LLC
#J-18808-Ljbffr
Responsibilities
Under general supervision of a Senior Manager, the Sr Field Reimbursement Specialist (Regional FRM Lead) will plan and engage with customers, educate on access and reimbursement topics relevant to assigned client product, track progress and evaluate results of activities, and lead or direct more complex projects or aspects of projects.
Operate with reasonable latitude for un-reviewed action or decision, requiring minimum correction on final review of work product. Work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide education through a focused effort on healthcare providers in community, institutional, and academic medical settings.
Manage daily activities that support appropriate patient access to our client2;s products in provider offices and healthcare institutions, acting as a liaison to other patient assistance and reimbursement support services offered by our clients. The scope and approach are defined by the client2;s legal and compliance departments and may vary.
Activities may include, but are not limited to:
Review patient insurance benefit options with appropriate authorizations
Validate prior authorization requirements
Understanding of Specialty Pharmacy processes
Educate provider office staff and practice managers on coordination needed to support client product, including infrastructure for in-office administration (buy and bill and monitoring of product) and updates on coverage and payer policy changes within assigned territories
Educate provider office staff on payer coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeals processes
Identify alternate funding/financial assistance programs
Act as SME about coverage, specific product codes, including patient-specific access questions
Effective account management: uncovering customer insights through questioning, critical thinking and problem solving; disseminating data and information to partners
Review appropriate billing and coding for products
Probe to understand office processes and root causes of access or reimbursement issues
Drive resolution of reimbursement issues through an educational approach
Collaborate with client patient services program representatives
Educate physician office staff on the use of client patient assistance and support line reimbursement services, including web-based provider programs
Deliver interactive educational presentations at various provider sites of service
Provide information on relevant reimbursement topics related to client products based on client approval
Communicate and collaborate with client cross-functional teams to include sales representatives, account managers and district managers
Prioritize activities and adhere to processes to maximize coverage of accounts and track progress while following policies, procedures, and performance metrics
Leverage reimbursement knowledge and resources to aid accounts and build customer partnerships
Lead internal team training and meetings
Serve as a peer buddy and mentor to colleagues
Lead geography support for team members and manager
Develop and execute business plan for assigned territory
Performs other related duties as assigned
Experience and Education Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support. Experience within healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred.
Bachelor's degree preferred.
Minimum of 7 years of experience
Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment.
Skills and Abilities
Ability to effectively manage multiple client relationships and customer interactions
Ability to manage and support external meetings, presentations, and client interactions
Ability to lead and work in a matrix environment
Proven teamwork and collaboration skills in highly matrixed and cross-functional organizations
Ability to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the role
Ability to work with client program vendors to deliver a positive customer experience
Sound judgment and decision-making ability with emotional intelligence
Creative problem-solving skills
Ability to manage competing priorities with a sense of urgency
Demonstrated territory and coordination management skills
Results oriented; excellent communication skills for presenting complex information
Ability to build and maintain relationships with business partners and healthcare professionals
Understanding of physician buy-and-bill vs. assignment of benefits to alternate sites of care
Deep understanding of medical and pharmacy benefits/policies
Understanding of Specialty Pharmacy vs. Specialty Distribution
Ability to educate on reimbursement and access issues to drive pull-through
Ability to conduct field-based reimbursement and access support, education, and consultation
Experience in revenue cycle, buy and bill, formulary, benefit investigations, prior authorization, coding, and appeals
Knowledge of private payer, Medicare, and Medicaid structures and policies
Understanding of patient support programs including financial and co-payment assistance
Strong listening and response skills
Team subject matter expertise and training delivery
Strong presentation skills, especially in small groups
Above-average computer skills: MS PowerPoint, MS Excel, MS Word, MS Outlook
What Cencora offers We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members9 ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we provide a comprehensive suite of benefits focusing on wellness across physical, emotional, financial, and social aspects. This includes support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. We offer training programs, professional development resources, mentorship opportunities, employee resource groups, and volunteer activities. For details, visit the following site: https://www.virtualfairhub.com/cencora
Salary Range Full time: $100,700 - 155,100. This salary range reflects a national average; actual range may vary by locale. State-specific locations may be up to 10% lower or 12% higher than the stated range in states including Colorado, California, Washington, New York, Hawaii, Vermont, Minnesota, Massachusetts, Illinois, and others.
Equal Employment Opportunity Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.
The company2;s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.
Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned.
.
Affiliated Companies Affiliated Companies: Cencora Patient Services, LLC
#J-18808-Ljbffr