Quality Recruiting. Established Experts.

Field Reimbursement Specialist

Reference Number: 3895
Location: MA

Our client is a clinical-stage biopharmaceutical company. They have asked us to assist them in their search for a Field Reimbursement Specialist.

Major tasks and responsibilities will include:

  • Provides expert guidance to imaging sites to ensure accurate claims submission, best practices sharing for prior authorization and appeals, scheduling tips, understanding of reimbursement landscape, etc.
  • Serves as liaison with providers with payers where appropriate.
  • Educates and supports referring physician offices with best practice sharing for prior authorizations and appeals.
  • Develops and maintains relationships with key customers.
  • Identifies and supports physicians to assist in outreach to payers.
  • Performs quarterly reviews with assigned customers to provide ongoing support and uncover payer issues. Escalates payer issues to Payer Relations Manager.
  • Coordinates with reimbursement support line consultants, where appropriate, to provide updates, guidance, and address challenges with reimbursement as reported by users.
  • Provides regular status reports and tracking of customer education/interaction and results.
  • Collaborates with other functional areas to ensure regional customer reimbursement support.
  • Other projects as determined through discussion and planning with Director of Patient Access & Healthcare Policy.

We seek candidates with the following qualifications:

  • Bachelor’s degree required.
  • Must have a minimum of 3 years working in reimbursement, managed care sales/marketing or related field.
  • Requires a minimum of 5 years of experience and success in the healthcare industry, preferably imaging, diagnostics, or pharmaceuticals.
  • Must be able to work directly with hospitals/imaging centers on payer specific issues.
  • Requires knowledge of medical benefit plan design (Commercial, Medicare, Managed Care).
  • The ability to lead or facilitate live training/education, and successfully manage high impact relationships and projects
  • Highly developed time management skills with demonstrated ability to meet deadlines and handle multiple priorities with a high degree of initiative required.
  • Well-developed analytical, problem solving, and influencing skills, appropriately balanced with strong interpersonal and teaming skills.
  • Excellent communication (written, verbal, and presentation) skills with the ability to interact with all levels of management for both internal and external customer base.
  • The ability to work effectively and independently from a home office but must be able to travel, as needed, up to 70% of the time.
  • Basic knowledge of compliance aspects relative to industry and reimbursement policy.

If interested, please email your resume as a Word attachment to us, reference 3895.  No calls or faxes, please. Include your daytime phone number and we will contact you confidentially or reply to your email.

Fairway Consulting Group is included in Hunt Scanlon’s list of Top 50 Healthcare & Life Sciences Search Firms.