Reimbursement Business Manager

3 weeks ago

Stamford, United States Regeneron Pharmaceuticals, Inc Full time

The Reimbursement Business Manager is a critical front-line member of the Regeneron Ophthalmology Field team. You will use your expertise and knowledge with all Regeneron customers, both internal and external. In this role, you will support physician offices throughout all facets of the reimbursement cycle and work to ensure the lines of communication remain open for existing and future Regeneron products. We always do what is right and seek to fully understand provider business drivers to help develop compliant approaches to account issues and management.

A Typical Day Might Look Like This:

Develop and execute account plans that build reimbursement confidence with customers (e.g. MD and staff) & support continued patient access.

Proactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers.

Develop collaborative relationships with Regeneron colleagues (ex. Regional Directors and Medical Specialists) to educate physician offices in coverage/coding of Regeneron products and support patient access to care.

Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes.

Anticipate and adapt to the customer’s needs, as well as market changes and challenges.

Demonstrate proactive planning and time management skills by the efficient and effective coverage of your assigned RBM Territory.

Establish positive working relationships with accounts (e.g. MD’s, Administrators & office staff) and effectively manage product concerns.

Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize basket of company approved access materials to support reimbursement confidence.

If This Looks Like You:

Business Acumen

Biologic market expertise (B&B/SP)

Reimbursement expertise or aptitude to learn

Strategic agility

Ability to use company technology

Collaboration

Ability to work across key/multiple stakeholders and build strong partnerships

Communication

Presentation skills: Ability to develop and deliver simple concise messages, tailored to the audience of all sizes

Results oriented

Not just focused on activity, but ensuring the activity is driving results for the business

Proactive: Does not need to be told what to do, looks for opportunities to drive value

Customer focused

Is dedicated to meeting the expectations and requirements of both internal and external customers

Flexibility/Adaptability: Ability to flex based on the needs of the business

To be considered you must haveaBachelor's degree from a four-year college or university. 5-8 years' pharmaceutical/biotech/device experience, including minimum of 3-5 years healthcare coverage, coding and/or reimbursement experience. Previous experience working with billing and medical claims personnel in various health care settings, including, but not limited to a physician office, hospital, HOPD or ASC. Shown expertise in supporting healthcare provider offices with coding, billing, and submissions in range of payer environments. Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives. We expect you to be familiar with CPT, HCPCS, ICD-9, revenue codes and DRG, coverage. Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur. Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies. Candidate must reside within assigned territory and have ability to travel 50%-70% of the time.

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