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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Managed Health Care and Access and Reimbursement, with a strong understanding of payer policies, coding, and billing requirements. Capable of educating healthcare providers on patient access programs and maintaining effective relationships within the territory.
Highest-signal resume keywords
Managed Health Care ExperiencePayer Account ManagementAccess And Reimbursement KnowledgeCoding And Billing RequirementsTerritory And Account Management Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient AccessReimbursement SupportPayer Policy ProcessesMedicare Parts A, B, C, And DCoding ChangesClaims-Submission ProcessesSpecialty Pharmacy NetworksAccess Issues ResolutionPatient Support ProgramsHealthcare Regulations
Soft Skills
Relationship BuildingCommunication SkillsProblem-Solving
Certifications & Qualifications
Valid Driver's LicenseHCIR Credentialing Requirements
Industry Keywords
Managed CareReimbursement DynamicsPayer TrendsHealthcare Provider EducationAccess Resources
About the role
Key responsibilities & impact- Act as an alternative in-office resource for HCP questions about patient access
- Call directly on HCP offices within the assigned geography
- Answer questions about patient access and reimbursement for Duopa, Vyalev, and Juvmo
- Educate HCPs on patient support programs and access/reimbursement tools and services
- Educate on product-specific acquisition and access options, including specialty pharmacy networks and specialty distribution
- Provide resources to address access issues
- Explain national and regional payer policies, payer issues, coding changes, and claims-submission processes
- Liaise with AbbVie’s Access and Reimbursement support center regarding prescription status and program eligibility
- Report payer trends for approved products to Patient Services and MHC account management teams
- Establish and maintain relationships with providers within the territory
- Remain current on managed care, reimbursement, and policy activities
Requirements
What you’ll need- At least 3 years of experience in Managed Health Care, Payer Account Management, and/or Access and Reimbursement
- Understanding of rules, regulations, and risks associated with reimbursement support services
- Thorough understanding of technical payer policy processes, systems, and requirements for specialty-medicine coverage, coding, and payment
- Strong understanding of national and regional coding and billing requirements across care settings
- Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Excellent territory and account management skills
- Bachelor's degree
- Personal auto, company car, truck, or powered material-handling equipment for driving
- Valid driver's license
- Ability to pass a pre-employment drug screening test and meet safe-driving requirements
- Must satisfy applicable HCIR credentialing requirements and be in good standing or eligible to obtain credentials, potentially including background checks, drug screens, immunization/vaccination proof, fingerprinting, and specific state or city licenses
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Eligibility to participate in long-term incentive programs
- Company car or truck may be used for driving responsibilities
- HCIR credentialing resources from AbbVie
- Equal opportunity employer; Veterans/Disabled applicants supported
