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Coherus Oncology · 4 months ago

Field Reimbursement Manager - East and South

United States - East and South

Full-time

Onsite

Mid, Senior Level

$165K/yr - $190K/yr

5+ years exp

Coherus Biosciences is focused on optimizing access to their oncology product portfolio, and they are seeking a Field Reimbursement Manager to help minimize access and reimbursement barriers for patients and providers. The FRM will work strategically with customers and accounts to address complex patient access issues and provide education on reimbursement support programs.

BiotechnologyHealth CareMedicalOncologyTherapeutics

Growth Opportunities

Responsibilities

Partner with internal and external stakeholders to identify, anticipate and address patient and practice reimbursement issues

Collaborate with Field Sales to identify facilities and practices that need reimbursement education and support regarding Coherus products

Provide insights and updates regarding product and support service integration at accounts

Educate facility staff on policies related to product acquisition, inventory management, and all payer polices related to support full integration of product into the practice workflow

Provide coverage, coding, and reimbursement information to key staff members (i.e., practice administrators, reimbursement staff, and providers) in order to appropriately support patient access

Collaborate with field facing "One Team" to compliantly share insights into customer needs, potential barriers, and payer issues/opportunities for access at practices

Communicate and explain payer policy updates or system changes that impact access

Proactively communicate Coherus COMPLETE™ so that office staff is fluent in how to use patient access programs and services

Address questions associated with patient coverage, access, and reimbursement from accounts in collaboration and coordination with patient services as directed by policy and procedure

Conduct frequent claim reviews with practices to ensure appropriate reimbursement of Coherus products

Maintain a deep understanding of Coherus policies and requirements and perform the role in a compliant manner consistent with company guidance

Keep abreast of customer and market access industry trends

Qualification

Healthcare coverageCodingReimbursementOncology experienceBuyBill productsMedicare Part BCPT codingICD-10 revenue codesAnalytical skillsCommunication skillsCollaboration skills

Required

5+ years of commercial experience in the pharmaceutical or biotech industry

3+ years of experience in healthcare coverage, coding and/or reimbursement

Direct experience with Buy and Bill products, Medicare Part B and Miscellaneous J-Codes required

Bachelor's degree from a four-year college or university

Previous experience working with billing and medical claims personnel in various health care settings, including physician office, hospital, HOPD and ASC

Shown expertise in supporting healthcare provider offices with coding, billing, and submissions in range of payer environments

Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives

Familiar with CPT, HCPCS, ICD-10 revenue codes

Familiarity with health insurance claim forms, explanation of benefits, prior authorization forms, and EMR/Practice Mgmt. systems, to troubleshoot cases where billing, claims submission or documentation errors may occur

Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies

Candidate must reside within assigned territory and have the ability to travel up to 70%

Preferred

Oncology experience strongly preferred

Company

Coherus Oncology

Coherus Oncology is a fully integrated commercial-stage innovative oncology company with an approved next-generation PD-1 inhibitor, LOQTORZI, and a promising pipeline that includes two mid-stage clinical candidates targeting liver, lung, head & neck, and other cancers.

Founded in 2010

Redwood City, California, USA

201-500 employees