Field Reimbursement Specialist

Summary

Cencora is an innovative company focused on creating healthier futures. The Field Reimbursement Specialist serves as a subject-matter expert on reimbursement, access, and coverage issues, ensuring patients can access specialty medications by educating healthcare providers and resolving access barriers.

Responsibilities

• Educating providers and their office staff on access and reimbursement topics using client-approved resources
• Supporting appropriate patient access to the client’s products by resolving reimbursement and coverage challenges
• Collaborating with other patient assistance and reimbursement support services offered by the client
• Educate provider office staff and practice managers on insurance issues relevant to the supported clients product, and inform the staff of important coverage and payer policy changes within assigned territories
• Educate provider office staff with understanding the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes
• Probe to understand office processes and ability to discern root causes of access or reimbursement issues
• Deliver interactive educational presentations at various provider sites of service
• Provide information on relevant reimbursement topics related to our client’s products based on client’s approval
• Performs other related duties as assigned

Skills

• High School Diploma/GED required
• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners
• Understands the dynamics of specialty pharmacy
• Experience in revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes
• Deep understanding of pharmacy benefits/policies
• Strong time management and planning skills
• Proficient in Microsoft Word, Powerpoint, Excel, and Outlook
• Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that includes but may not be limited to Florida
• Candidates must be willing to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment
• Bachelor's degree or relevant practice management experience
• Previous experience as Field Reimbursement Manager/Specialist
• Previous experience working in healthcare directly resolving pharmacy benefit access issues
• Experience with extensive travel

Qualifications

Must Haves

• High School Diploma/GED required
• Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners
• Understands the dynamics of specialty pharmacy
• Experience in revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes
• Deep understanding of pharmacy benefits/policies
• Strong time management and planning skills
• Proficient in Microsoft Word, Powerpoint, Excel, and Outlook
• Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that includes but may not be limited to Florida
• Candidates must be willing to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment

Nice to Haves

• Bachelor's degree or relevant practice management experience
• Previous experience as Field Reimbursement Manager/Specialist
• Previous experience working in healthcare directly resolving pharmacy benefit access issues
• Experience with extensive travel

Benefits

• Medical, dental, and vision care
• Backup dependent care
• Adoption assistance
• Infertility coverage
• Family building support
• Behavioral health solutions
• Paid parental leave
• Paid caregiver leave
• A variety of training programs
• Professional development resources
• Opportunities to participate in mentorship programs, employee resource groups, volunteer activities