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About the Role
Manage an assigned territory to support patient reimbursement and services for a specific drug, including benefit investigation, prior authorization, claims assistance, and appeals. Educate offices on payer landscape and available services through remote and on-site training. Build relationships with physician offices and manufacturer representatives. Work independently and collaboratively with internal support services. Interact with providers and staff to arrange site visits and trainings. Possess solid knowledge of Medicare and Commercial insurance plans. This position requires travel, project management, and/or account coordination.
Responsibilities
- Provide on-site and on-demand education to office staff regarding reimbursement challenges and support services.
- Conduct an average of 15 on-site/virtual interactions per week.
- Record daily activities in FRM CRM and report weekly to management.
- Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and patient communication streams.
- Capture and report monthly educational topics to clients.
- Provide reimbursement support for case management, billing and coding updates, claims submission, Specialty Pharmacy, medical benefit interpretation, medical necessity, claims and appeal assistance, co-pay assistance, and patient assistance programs.
- Collaborate with case managers for escalations, tracking interactions in FRM CRM and hub system.
- Set up appointments and complete outbound calls to targeted offices.
- Assist in completing backlog casework and perform day-to-day in-office work.
- Interface with physicians and manufacturer representatives to exchange patient and provider information.
- Track all interactions and activities in FRM CRM for reporting to management and clients.
- Monitor program performance for physicians and manufacturer representatives.
- Research and compile provider/manufacturer representative information for the reimbursement database, including creating account profiles in FRM CRM.
Requirements
- 4-year degree in a related field or equivalent experience.
- 4+ years of healthcare-related reimbursement experience.
- Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
- Experience supporting oncology products (preferred).
- Healthcare industry experience including insurance verification, prior authorizations, and/or claim adjudication, or experience in physician's offices/clinics.
- Medicare and commercial insurance coverage experience.
- Ability to deliver and document benefit investigation outcomes and relay status reports.
- Proven presentation skills.
- Ability to effectively handle multiple priorities.
- Excellent organizational skills.
- Strong computer literacy, including PowerPoint and Web Meeting experience.
- Previous field experience (a plus).
- Previous experience with specialty pharmacy (a plus).
- Account management experience (a plus).
- Must reside in the assigned territory.
- Ability to travel 80% (4 days a week) via automobile or plane.
- Valid driver's license with a clean driving record/MVR.
Skills
- Medical reimbursement
- Buy & Bill
- Specialty Pharmacy
- Insurance verification
- Prior authorizations
- Claim adjudication
- Medicare and commercial insurance coverage
- Presentation
- Organizational
- Computer literacy
- PowerPoint
- Web Meeting
- Field experience
- Account management
- Interpersonal communication
- Written communication
- Oral communication
- Problem solving
- Decision-making
Location
- Reside in assigned territory
- Travel 80% (4 days a week)
Experience Level
- 4+ years of healthcare related reimbursement experience
Education Level
- 4-year degree in related field or equivalent experience
Salary/Compensations
- $88,300 - $147,100 (Base Pay Range)
- Annual bonus or long-term incentive opportunities may be offered.
About the Company
- McKesson is an impact-driven, Fortune 10 company touching virtually every aspect of healthcare.
- Delivers insights, products, and services to make quality care more accessible and affordable.
- Focuses on the health, happiness, and well-being of employees and those served.
- Fosters a culture of growth, impact, and empowerment for new ideas.
- Aims to shape the future of health for patients, communities, and people.
Equal Opportunity
- McKesson is an Equal Opportunity Employer.
- Provides equal employment opportunities without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category.
- Committed to offering opportunities to all job seekers, including those with disabilities.
- Offers reasonable accommodation for job search or application; contact Disability_Accommodation@McKesson.com (US) or Accessibility@mckesson.ca (Canada).