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Job Details:
The Field Reimbursement Specialist (FRS) serves as a subject‐matter expert on reimbursement, access, and coverage issues. The FRS plays a critical role in ensuring patients can access specialty medications by educating healthcare providers and their staff on complex insurance and reimbursement processes and resolving access barriers. FRSs act as liaisons between providers, manufacturers, pharmacies, and payers to navigate reimbursement challenges. They meet directly with healthcare providers and their office staff to provide education on the reimbursement and access considerations specific to a specialty medication. Preferred candidate must live within a reasonable commuting distance of a major airport in the listed location and be able to travel up to 80% within a territory that includes, but may not be limited to, Florida. This role requires weekly travel, including potential overnight stays, to healthcare offices within a designated territory.
Key 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.
Typical Day:
Educate provider office staff and practice managers on insurance issues relevant to the supported client product and inform the staff of important coverage and payer policy changes within assigned territories. Educate provider office staff on payer coverage management strategies for the product, including coding, billing, formulary, prior authorization, and appeal processes. Probe to understand office processes and 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 approval. Perform other related duties as assigned. SkillsAnd Abilities Ability to conduct field‐based reimbursement and access support, education, and consultation to key account customers and cross‐functional partners. Understanding of 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. Proficiency in Microsoft Word, PowerPoint, Excel, and Outlook.
Education And Experience:
High School Diploma/GED required. Bachelor's degree or relevant practice management experience preferred. Previous experience as Field Reimbursement Manager/Specialist preferred. Previous experience working in healthcare directly resolving pharmacy benefit access issues. Experience with extensive travel. Candidate must be willing to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment. What Cencora offers We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This includes support for working families such as backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. Training programs, professional development resources, mentorship programs, employee resource groups, volunteer activities, and more are also available. For details, visit https://www.virtualfairhub.com/cencora 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. 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 consistent with legal requirements. If you wish to request an accommodation, please call 888.692.2272 or email hrsc@cencora.com. Affiliated Companies Affiliated Companies: Cencora Patient Services, LLC
