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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 ReimbursementPayer Policy UnderstandingAccount Management Skills
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 providers on resources addressing access issues
- Provide local expertise on national and regional payer policies, payer issues, coding changes, and appropriate 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
- Perform field-based work within a reasonable distance of the primary city
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 strongly preferred
- Demonstrated understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations
- Strong understanding and ability to communicate technical coding and billing requirements at the national and regional level across all settings of care
- Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Satisfy all applicable health care industry representative credentialing requirements and be in good standing and/or eligible to obtain them
- 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
- Extensive experience educating others on payer processes, coverage requirements, and access-related situations for specialty medicines preferred
- Strong track record of leadership within current role preferred
- Willingness and ability to travel 50% of the time
Benefits
Comp & perks- Paid time off, including vacation, holidays, and sick leave
- Medical, dental, and vision insurance
- 401(k)
- Participation in long-term incentive programs
- Potential bonus, commission, incentive, and other compensation, subject to Company discretion
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 PolicyAffordability SupportPatient Support Program OperationsSpecialty Distribution
Soft Skills
Territory ManagementRelationship BuildingCommunication SkillsLeadership
Certifications & Qualifications
Healthcare Industry Representative Credentialing
Industry Keywords
Specialty Pharmacy NetworksBuy-and-Bill ProductsPayer TrendsManaged CareAccess Issues