Syneos Health/ inVentiv Health Commercial LLC
Field Reimbursement Specialist
Syneos Health/ inVentiv Health Commercial LLC, Columbia, South Carolina, us, 29228
Description
The Field Reimbursement Specialist (FRS) will be responsible for the management of defined accounts in a specified geographic region in the ophthalmic therapeutic area, specifically supporting our client\'s products. The FRS will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of the reimbursement process, field reimbursement services, and patient support programs. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution and will need knowledge of and experience with patient health information (PHI). Field Reimbursement Specialists manage daily activities that support appropriate patient reimbursement to our client\'s products in provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Activities include, but are not limited to: Act as an extension of the product providing live one-on-one coverage support. Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements, procedures, and forms. Reviewing patient-specific information in cases where the site has requested assistance in resolving issues or coverage challenges. Reviewing patient insurance benefit options. Identifying alternate funding/financial assistance programs. Minimum Qualifications & Education
Bachelor\'s degree or a minimum of three years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales, or a minimum of six years of biologic coordinator experience. Minimum two years of access and reimbursement, managed care, and/or billing and coding support experience. Experience working with Buy and Bill products and a thorough understanding of the entire reimbursement process from script to injection. Ophthalmic, retina specialists and biosimilar experience preferred. Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus. Why Syneos Health
Our ability to collaborate and problem-solve makes a difference in patients\' lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our partnerships create multiple career paths and opportunities for growth. Syneos Health is an equal opportunity employer. We encourage applicants from all backgrounds and experiences. We also encourage you to join our Talent Network to stay connected to additional career opportunities. Equal Opportunity
Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled). Vaccination and Benefits
Syneos Health has a voluntary COVID-19 vaccination policy. We encourage all employees to be fully vaccinated. Some local governments or customers may require vaccination. Benefits for this position include a compensation package, health benefits (Medical, Dental, Vision), 401k with company match, flexible PTO and sick time; eligibility for paid sick time varies by location. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.
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The Field Reimbursement Specialist (FRS) will be responsible for the management of defined accounts in a specified geographic region in the ophthalmic therapeutic area, specifically supporting our client\'s products. The FRS will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of the reimbursement process, field reimbursement services, and patient support programs. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution and will need knowledge of and experience with patient health information (PHI). Field Reimbursement Specialists manage daily activities that support appropriate patient reimbursement to our client\'s products in provider offices and work as a liaison to other patient assistance and reimbursement support services offered by our clients. Activities include, but are not limited to: Act as an extension of the product providing live one-on-one coverage support. Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements, procedures, and forms. Reviewing patient-specific information in cases where the site has requested assistance in resolving issues or coverage challenges. Reviewing patient insurance benefit options. Identifying alternate funding/financial assistance programs. Minimum Qualifications & Education
Bachelor\'s degree or a minimum of three years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales, or a minimum of six years of biologic coordinator experience. Minimum two years of access and reimbursement, managed care, and/or billing and coding support experience. Experience working with Buy and Bill products and a thorough understanding of the entire reimbursement process from script to injection. Ophthalmic, retina specialists and biosimilar experience preferred. Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus. Why Syneos Health
Our ability to collaborate and problem-solve makes a difference in patients\' lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our partnerships create multiple career paths and opportunities for growth. Syneos Health is an equal opportunity employer. We encourage applicants from all backgrounds and experiences. We also encourage you to join our Talent Network to stay connected to additional career opportunities. Equal Opportunity
Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled). Vaccination and Benefits
Syneos Health has a voluntary COVID-19 vaccination policy. We encourage all employees to be fully vaccinated. Some local governments or customers may require vaccination. Benefits for this position include a compensation package, health benefits (Medical, Dental, Vision), 401k with company match, flexible PTO and sick time; eligibility for paid sick time varies by location. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.
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