Updated:
January 28, 2026 Location:
New York, NY, United States Job ID:
13736-OTHLOC-CZSLYfwk
Job Overview The Virtual Field Reimbursement Manager (VFRM) will be responsible for the management of defined accounts in a specified geography. The VFRM will execute a strategic plan through partnership with internal and external stakeholders, including call center services, sales, market access, and other collaboration partners. The VFRM will serve as a reimbursement subject matter expert and will provide office education throughout the reimbursement process, including formulary coverage, utilization management criteria, insurance procedures, benefits investigation, prior authorization, appeal, and claims resolution.
Core Responsibilities
Serve as the primary virtual reimbursement contact for assigned accounts, responding to reimbursement requests.
Serve as payer expert and interpret and communicate payer changes and policies for Medicare, Medicaid, and Commercial plans to key stakeholders in a timely manner.
Provide education and support to prescribing physicians and support staff regarding reimbursement, coding, and patient access issues.
Benefit verification results.
Prior authorization requirements.
Appeals processes.
Claims submission and denial troubleshooting.
Site of Care considerations (Buy and Bill).
CPT, HCPCS/J-codes, ICD-10, diagnosis codes.
Assist with claims issue resolution, including underpayments, denials, and requests for additional documentation.
Track payer-specific challenges and communicate access or time‑to‑therapy trends, while triaging complex reimbursement or policy issues to appropriate internal partners for escalation when needed.
Maintain detailed documentation of reimbursement cases, trends, and outcomes to identify recurring access barriers.
Manage multiple reimbursement cases simultaneously while meeting service‑level expectations.
Cross‑Functional Interaction
Coordinate virtually and in person as needed with internal partners to share payer insights and recurring reimbursement challenges, and support consistent messaging related to access pathways.
Provide clear, timely updates on case status and resolution outcomes using approved internal tools and processes.
Participate in internal meetings and trainings to stay aligned on reimbursement strategy and product updates.
Qualifications
5+ years of pharmaceutical and/or biotech experience.
1+ year of experience in field reimbursement.
Ability to solve access issues related to specialty pharmacy channel.
Experience in oncology is nice to have, not required.
Ability to travel 15% – 80% virtual and 15% live.
Compensation The annual base salary for this position ranges from $145,000 to $150,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate’s qualifications, skills, competencies, and proficiency for the role. Some positions may include a company car or car allowance and eligibility to earn commissions/bonus based on company and/or individual performance.
EEO & COVID Policy Syneos Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, marital status, ethnicity, national origin, sex, gender identity, sexual orientation, protected veteran status, disability, or any other legally protected status. If you are an individual with a disability who requires reasonable accommodation to complete any part of our application process, including the use of this website, please contact us to provide alternate means to submit your application. Syneos Health has a voluntary COVID‑19 vaccination policy and requires proof of vaccination for certain roles as mandated by local government or customer requirements.
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January 28, 2026 Location:
New York, NY, United States Job ID:
13736-OTHLOC-CZSLYfwk
Job Overview The Virtual Field Reimbursement Manager (VFRM) will be responsible for the management of defined accounts in a specified geography. The VFRM will execute a strategic plan through partnership with internal and external stakeholders, including call center services, sales, market access, and other collaboration partners. The VFRM will serve as a reimbursement subject matter expert and will provide office education throughout the reimbursement process, including formulary coverage, utilization management criteria, insurance procedures, benefits investigation, prior authorization, appeal, and claims resolution.
Core Responsibilities
Serve as the primary virtual reimbursement contact for assigned accounts, responding to reimbursement requests.
Serve as payer expert and interpret and communicate payer changes and policies for Medicare, Medicaid, and Commercial plans to key stakeholders in a timely manner.
Provide education and support to prescribing physicians and support staff regarding reimbursement, coding, and patient access issues.
Benefit verification results.
Prior authorization requirements.
Appeals processes.
Claims submission and denial troubleshooting.
Site of Care considerations (Buy and Bill).
CPT, HCPCS/J-codes, ICD-10, diagnosis codes.
Assist with claims issue resolution, including underpayments, denials, and requests for additional documentation.
Track payer-specific challenges and communicate access or time‑to‑therapy trends, while triaging complex reimbursement or policy issues to appropriate internal partners for escalation when needed.
Maintain detailed documentation of reimbursement cases, trends, and outcomes to identify recurring access barriers.
Manage multiple reimbursement cases simultaneously while meeting service‑level expectations.
Cross‑Functional Interaction
Coordinate virtually and in person as needed with internal partners to share payer insights and recurring reimbursement challenges, and support consistent messaging related to access pathways.
Provide clear, timely updates on case status and resolution outcomes using approved internal tools and processes.
Participate in internal meetings and trainings to stay aligned on reimbursement strategy and product updates.
Qualifications
5+ years of pharmaceutical and/or biotech experience.
1+ year of experience in field reimbursement.
Ability to solve access issues related to specialty pharmacy channel.
Experience in oncology is nice to have, not required.
Ability to travel 15% – 80% virtual and 15% live.
Compensation The annual base salary for this position ranges from $145,000 to $150,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate’s qualifications, skills, competencies, and proficiency for the role. Some positions may include a company car or car allowance and eligibility to earn commissions/bonus based on company and/or individual performance.
EEO & COVID Policy Syneos Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, marital status, ethnicity, national origin, sex, gender identity, sexual orientation, protected veteran status, disability, or any other legally protected status. If you are an individual with a disability who requires reasonable accommodation to complete any part of our application process, including the use of this website, please contact us to provide alternate means to submit your application. Syneos Health has a voluntary COVID‑19 vaccination policy and requires proof of vaccination for certain roles as mandated by local government or customer requirements.
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