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Field Reimbursement

Overview

Do you have a noticeable passion for results?

Connecting people with the information they need is your forte. You're a unifier by nature and you're at your best when setting others up for success. Your ability to clear the way, extrapolate intricate details, attend to complex situations and serve as a trusted go-between make you a perfect fit for a Field Access Specialist role at Syneos Health.

Responsibilities

The Field Reimbursement Specialist (FRS) will be responsible for the management of defined accounts in a specified geographic region in the bone health 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 Reimbursement process, field reimbursement services, and patient support program. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI).

In this role, the FRS will demonstrate unwavering support and consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients. The FRS will have a direct impact on a patient's ability to access the therapies they need. Additional responsibilites include:

  • Manage daily activities that support appropriate patient access to our client's products in the provider offices and work as a liaison to other patient assistance and access support services offered by our clients (i.e. HUB, Call Center, Specialty Pharmacy Services)
  • Act as an extension of the call center and/or HUB and provide live one-on-one coverage support
  • Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner
  • Offer office education during the entire access process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution
  • Educate offices using approved materials provided by the client
  • Review patient-specific information in reimbursement cases where the office has specifically requested assistance in resolving access issue or coverage challenge
  • Educate physician office staff on the use of our client's patient support services, including web based provider portals


Job Requirements

Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:

  • A Bachelor's Degree, relevant specific practice management experience preferred
  • Minimum two years of experience in public or private third party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
  • Experience with specialty/biologic self-injectable (pharmacy benefit) or physician administered (buy and bill/medical benefit) products
  • Demonstrated ability to educate offices on access processes - including but not limited to:
  • Experience educating HCPs on client specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.)
  • Experience delivering educational presentations
  • Advanced knowledge of medical insurance terminology
  • Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B - for buy & bill products and Part D for Pharmacy products)
  • Ability to manage ambiguity & problem solve
  • Ability to manage expenses within allocated budgets


At Syneos Health, we believe in providing an environment and culture in which our people can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality of life balance.

Why Syneos Health? Join a game-changing global company that is reinventing the way therapies are developed and commercialized. Here, you're essential in solving and executing against today's toughest commercialization challenges facing the world's leading healthcare companies. From the very beginning, you'll be supported by team members who, like you, aren't afraid to try something new. You'll gain exposure and work in a dynamic environment to create better, smarter, faster ways to get biopharmaceutical therapies to patients.

WORK HERE MATTERS EVERYWHERE | How will you accelerate bringing Market Access solutions to clients?

Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

Field Reimbursement

Washington, DC
Full Time

Published on 09/18/2020