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Field Reimbursement Specialist
Cencora. Educate healthcare providers, office staff, practice managers, and key account customers on reimbursement, access, insurance, coding, billing, formulary, prior authorization, and appeal processes .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in reimbursement processes, patient access support, and healthcare provider education, with a strong understanding of pharmacy benefits and coding practices. Capable of conducting field-based consultations and delivering educational presentations to enhance provider knowledge and resolve access challenges.
Highest-signal resume keywords
Field Reimbursement ManagementPrior Authorization Certified Specialist (PACS)Revenue Cycle ManagementPharmacy Benefit Access ResolutionHealthcare Provider Education
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Reimbursement ProcessesCodingBillingFormulary ManagementPrior AuthorizationAppeals ProcessesBenefit InvestigationsSpecialty Pharmacy DynamicsMicrosoft WordMicrosoft Excel
Soft Skills
Time ManagementPlanningCollaborationCommunication
Tools & Technologies
Microsoft PowerPointMicrosoft Outlook
Certifications & Qualifications
Prior Authorization Certified Specialist (PACS)
Industry Keywords
HealthcarePatient AccessPharmacy BenefitsInsuranceCoding Practices
About the role
Key responsibilities & impact- Educate healthcare providers, office staff, practice managers, and key account customers on reimbursement, access, insurance, coding, billing, formulary, prior authorization, and appeal processes
- Support patient access to client products by resolving reimbursement and coverage challenges
- Act as a liaison between providers, manufacturers, pharmacies, and payers
- Collaborate with patient assistance and reimbursement support services
- Inform office staff about coverage and payer policy changes within assigned territories
- Probe office processes and identify root causes of access or reimbursement issues
- Deliver interactive educational presentations at provider sites of service
- Provide client-approved reimbursement information about client products
- Travel weekly, potentially including overnight stays, to healthcare offices within the designated territory
- Perform other related duties as assigned
Requirements
What you’ll need- High School Diploma/GED required
- Bachelor's degree or relevant practice management experience preferred
- Previous experience as Field Reimbursement Manager/Specialist preferred
- Previous experience working in healthcare directly resolving pharmacy benefit access issues
- Experience with extensive travel
- Must be willing to obtain a Prior Authorization Certified Specialist (PACS) certification within the first six months of employment
- Ability to conduct field-based reimbursement and access support, education, and consultation
- Understanding of specialty pharmacy dynamics
- Experience in revenue cycle, formulary, benefit investigations, prior authorization, coding, and appeals processes
- Deep understanding of pharmacy benefits/policies
- Proficient in Microsoft Word, PowerPoint, Excel, and Outlook
- Must live within a reasonable commuting distance of a major airport in the listed location
- Must be able to travel up to 80% within a territory including Southern California, Arizona, Utah, Colorado, Las Vegas metro, and New Mexico
- Strong time management and planning skills
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