Field Reimbursement Specialist

1 week ago


Houston, TX, United States Syneos Health inVentiv Health Commercial LLC Full time

Description

The Field Reimbursement Specialist (FRS) will be responsible for the management of defined accounts in a specified geographic region in the ophthalmic therapeutic area, specifically supporting our client's products.

The FRS will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of reimbursement process, field reimbursement services, and patient support program. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI).

Field Reimbursement Specialists manage daily activities that support appropriate patient reimbursement to our client's products in the provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Activities include, but are not limited to:

  • Act as an extension of the product providing live one-on-one coverage support.
  • Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms
  • Reviewing patient-specific information in cases where the site has specifically requested the assistance in resolving any issues or coverage challenges.
  • Reviewing patient insurance benefit options
  • Identifying alternate funding/financial assistance programs

Minimum Qualifications & Education:

  • Bachelor's degree or a minimum of three years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales, or a minimum of six years of biologic coordinator experience.
  • Minimum two years of access and reimbursement, managed care, and/or billing and coding support experience
  • Experience working with Buy and Bill products and a thorough understanding of the entire reimbursement process from script to injection required
  • Ophthalmic, retina specialists and biosimilar experience preferred
  • Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus

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.

Work Here Matters Everywhere | How are you inspired to change lives?

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.


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