Field Reimbursement Specialist

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.

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

Skills

• 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
• Bachelor's degree or specific Practice Management experience
• Project management skills
• Experience with extensive travel

Benefits

• Medical, dental, and vision care
• Backup dependent care
• Adoption assistance
• Infertility coverage
• Family building support
• Behavioral health solutions
• Paid parental leave
• Paid caregiver leave
• Variety of training programs
• Professional development resources
• Opportunities to participate in mentorship programs
• Employee resource groups
• Volunteer activities

Company Overview