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Cencora · 3 weeks ago

Field Reimbursement Specialist

New York, NY

Full-time

Hybrid

New Grad, Entry Level

$89K/yr - $127K/yr

Cencora is an innovative company focused on creating healthier futures for people and animals. The Field Reimbursement Specialist is responsible for providing field support for patient access to specified products, resolving complex reimbursement issues, and educating healthcare provider staff on access and reimbursement topics.

Emergency MedicineEnterprise SoftwareHealth CareMedicalPharmaceutical

Responsibilities

Educate provider office staff and practice managers on logistics needed to support client product, including infrastructure needed to support in-office administration including buy and bill and monitoring of product, and important coverage and payer policy changes within assigned territories

Educate provider office staff with understanding the payers’ coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes

Probe to understand office processes and ability to 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 our client’s products based on client’s approval

Performs other related duties as assigned

Qualification

Reimbursement expertisePatient access supportPrior Authorization CertificationRevenue cycle experienceProject management skillsEducational presentation skillsCommunication skillsProblem-solving skills

Required

High School Diploma/GED required

Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment

Ability to conduct field-based reimbursement and access support, education, and consultation to key account customers and cross-functional partners

Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution

Broad understanding of the physician buy-and-bill model vs. 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

Live within a reasonable commuting distance of a major airport in the listed location and be able to travel within a territory that includes but may not be limited to New York City, NY, Brooklyn, NY, Queens, NY, and Long Island, NY