Job Description
The Field Reimbursement Manager (FRM) supports healthcare provider offices by delivering expert education and assistance with patient access and reimbursement for a designated pharmaceutical product. This role is responsible for executing field-based and virtual engagements related to Benefit Investigation, Prior Authorization, Claims and Appeals , and other patient support services. The FRM builds trusted relationships with providers and collaborates closely with manufacturer partners and internal support teams to drive optimal access solutions and ensure a positive experience across stakeholders.
Key Responsibilities:
Conduct on-site and virtual educational sessions (including Lunch and Learns) focused on reimbursement challenges and available support services.
Provide ongoing education and office interaction covering topics such as benefit investigation, prior authorization processes, payer coverage (Medicare and Commercial), and patient communication strategies.
Offer hands-on reimbursement case support, including assistance with billing and coding updates, claims submission, medical benefit interpretation, understanding of medical necessity, and appeals processing.
Communicate information related to co-pay assistance and patient support programs, while collaborating with both internal hub services and external stakeholders to maintain workflow efficiency and meet program service level agreements.
Initiate and complete outbound calls to schedule office visits and follow up on case backlogs. Conduct day-to-day in-office work and interface directly with physicians and manufacturer representatives.
Track and report all activities and engagements through the designated FRM CRM system. Daily tracking and weekly reporting to management are required.
Monitor program performance across assigned territory via CRM dashboards. Identify and report performance trends through regular reporting cycles. Participate in client-initiated satisfaction surveys and other program evaluations.
Qualifications:
Minimum 3–5 years of experience in field-based reimbursement, patient services, or access support.
In-depth knowledge of Medicare, Medicaid, and Commercial insurance benefit structures.
Familiarity with specialty drug reimbursement models, buy-and-bill practices, and prior authorization workflows.
Excellent communication, presentation, and relationship-building skills.
Ability to work independently in a fast-paced, cross-functional environment.
Strong organizational and documentation skills; proficiency in Microsoft Office and CRM systems.
Ability and willingness to travel regionally, as required (up to 80%).
For immediate consideration, please forward your resume to: Yolanda.Deleon@Remx.com
Company Description
The professional staffing division of EmployBridge, America's Leading Workforce Specialist:
When our Talent is looking for their next opportunity, we know they are not just looking for their next paycheck. Our Recruiters are experts in their specialized fields and understand that making the right match between the candidate and the company, is the key to long term success. We are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.The professional staffing division of EmployBridge, America's Leading Workforce Specialist:\r\n\r\nWhen our Talent is looking for their next opportunity, we know they are not just looking for their next paycheck. Our Recruiters are experts in their specialized fields and understand that making the right match between the candidate and the company, is the key to long term success.\r\n\r\nWe are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
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