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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient access and reimbursement processes, including coding, billing, and prior authorization. Capable of delivering educational presentations and managing client relationships within the healthcare sector.
Highest-signal resume keywords
Patient Access SupportReimbursement EducationRevenue Cycle ManagementProject Management SkillsBilingual Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CodingBillingPrior AuthorizationAppeals ProcessesFormulary ManagementBenefit InvestigationsSpecialty Pharmacy KnowledgeBuy-And-Bill Model UnderstandingMedical Benefits UnderstandingPharmacy Benefits Understanding
Soft Skills
Customer EngagementPresentation SkillsProblem SolvingInterpersonal CommunicationConsultation Skills
Certifications & Qualifications
High School DiplomaGEDBachelor's Degree (Preferred)
Industry Keywords
HealthcarePatient Assistance ServicesProvider Office EducationAccess IssuesReimbursement Support
About the role
Key responsibilities & impact- Plan and engage with customers using client-approved resources to educate on access and reimbursement topics relevant to assigned client products
- Manage daily activities supporting appropriate patient access to client products in provider offices
- Act as a liaison to patient assistance and reimbursement support services offered by clients
- Travel weekly, sometimes overnight, to healthcare offices within a designated territory
- Educate provider office staff and practice managers on product-support logistics, in-office administration infrastructure, buy and bill, product monitoring, and coverage and payer policy changes
- Educate provider office staff on payer coverage management strategies, including coding, billing, formulary, prior authorization, and appeal processes
- Probe office processes and identify root causes of access or reimbursement issues
- Deliver interactive educational presentations at various provider sites of service
- Provide client-approved information on relevant reimbursement topics
- Perform other duties as assigned
Requirements
What you’ll need- Must reside within the listed territory: North Carolina, South Carolina, or Georgia
- Required to travel up to 80% within the specified area, including overnight trips
- Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners
- Understanding of Specialty Pharmacy versus Specialty Distribution
- Broad understanding of the physician buy-and-bill model versus assignment of benefits to alternate sites of care
- Experience in revenue cycle, buy and bill, including billing with miscellaneous J-code, formulary, benefit investigations, prior authorization, coding, and appeals processes
- Deep understanding of medical and pharmacy benefits/policies
- High School Diploma or GED required
- Bachelor's degree or specific Practice Management experience preferred
- Project management skills
- Experience with extensive travel
- Bilingual desirable but essential
Benefits
Comp & perks- Medical, dental, and vision care
- Backup dependent care
- Adoption assistance
- Infertility coverage
- Family building support
- Behavioral health solutions
- Paid parental leave
- Paid caregiver leave
- Training programs
- Professional development resources
- Mentorship programs
- Employee resource groups
- Volunteer activities