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Field Reimbursement Specialist
Cencora. Educate provider office staff and practice managers on logistics needed to support client products, including infrastructure for in-office administration, buy and bill, product monitoring, and coverage and payer policy changes .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in reimbursement processes, payer coverage management, and patient access strategies, with a strong focus on education and consultation for healthcare providers. Proficient in navigating the complexities of specialty pharmacy and revenue cycle management.
Highest-signal resume keywords
Reimbursement SupportPayer Coverage ManagementRevenue Cycle ManagementProject ManagementBilingual 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 ProcessesBenefit InvestigationsFormulary ManagementSpecialty Pharmacy KnowledgeBuy And Bill ModelMedical Benefits UnderstandingPharmacy Benefits Understanding
Soft Skills
Educational PresentationConsultationProblem SolvingInterpersonal CommunicationCustomer Engagement
Certifications & Qualifications
High School DiplomaGEDBachelor's Degree
Industry Keywords
Patient AccessHealthcareProvider EducationPractice ManagementField-Based Support
About the role
Key responsibilities & impact- Educate provider office staff and practice managers on logistics needed to support client products, including infrastructure for in-office administration, 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 discern 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 client products based on client approval
- Manage daily activities supporting patient access to client products in provider offices
- Act as a liaison to patient assistance and reimbursement support services
- Plan and engage with customers using client-approved resources
- Travel weekly, sometimes overnight, to healthcare offices within the designated territory
- Perform other duties as assigned
Requirements
What you’ll need- 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