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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in oncology and hematology-oncology, with a strong understanding of reimbursement dynamics, coding, and billing processes. Proven ability to educate healthcare professionals on patient support programs and establish relationships with providers while managing accounts effectively.
Highest-signal resume keywords
Oncology ExperienceHematology-Oncology ExperienceMedical Benefit ReimbursementAccount Management SkillsHCIR Credentialing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CodingBillingReimbursementBenefit VerificationPrior AuthorizationClaims SubmissionPayer PolicyPatient Support Program OperationsSpecialty DistributionSpecialty Pharmacy
Soft Skills
Communication SkillsRelationship BuildingCollaboration
Certifications & Qualifications
Bachelor's DegreeValid Driver's License
Industry Keywords
Managed CarePayer IssuesAccess IssuesTerritory ManagementField-Based Role
About the role
Key responsibilities & impact- Educate healthcare professionals on patient support programs, access and reimbursement support tools, and services
- Educate providers on product-specific acquisition and access options, including specialty pharmacy networks, specialty distribution, and white-bagging support
- Educate on resources available to address access issues
- Provide local expertise on national and regional payer policies, payer issues, coding changes, and claims submission processes
- Collaborate with Oncology internal stakeholders on key account management
- Report payer trends for approved products to Patient Services and MHC account management teams
- Establish and maintain relationships with appropriate providers within the territory
- Remain current on managed care, reimbursement, and policy activities
- Work in a field-based role with approximately 50% travel
Requirements
What you’ll need- Oncology and/or hematology-oncology experience strongly preferred
- Experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models preferred
- Understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations
- Ability to communicate technical coding and billing requirements at national and regional levels across care settings
- Understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Must satisfy applicable HCIR credentialing requirements and be in good standing or eligible to obtain required credentials
- Excellent territory and account management skills
- Bachelor's degree
- Valid driver's license
- 5 or more years of industry experience in access and reimbursement or account management preferred
Benefits
Comp & perks- Paid time off, including vacation, holidays, and sick leave
- Medical, dental, and vision insurance
- 401(k)
- Eligibility to participate in long-term incentive programs
