Field Reimbursement Manager

Title:Field Reimbursement Manager
Location: CA-Los Angeles

Job Description:

Adecco is assisting one of their top clients with their search for a Field Reimbursement Manager in the Los Angeles area.

This  role is paying $32-$44/hr.  and is remote.
The Field Reimbursement Manager is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences.

The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues.

Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and/or account coordination based on client expectation.

Key Responsibilities

1. Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include education and reimbursement support. On-site/virtual interactions will average 15 per week.

2. Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation.

3. Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs. FRM will collaborate with case manager on average of 4/month and ad hoc as needed for escalations.

4. Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.

5. Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting.

Minimum Job Qualifications (Knowledge, Skills, & Abilities):

Education/Training –
4-year degree in a related field or equivalent experience.

Business Experience –

Entry-level experience in project management.

Minimum of 8 years healthcare related reimbursement experience.

Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.

Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.

Must have Medicare and commercial insurance coverage experience.

Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis.

Strong customer service experience
Proven presentation skills and experience
Ability to effectively handle multiple priorities within a changing environment.
Excellent organizational skills
Strong Computer literacy to include PowerPoint and Web Meeting experience


Must be able to travel 80% (4 days a week) via automobile or plane

Must have a valid driver's license with a clean driving record/ MVR

The pay rate for the Field Reimbursement Manager is $32-$44/hr. As a reminder, this role is being recruited for by one of our National Recruitment Teams and not your local Branch. In order to be considered, please follow the steps included upon your application. If you are interested in this Field Reimbursement role APPLY NOW for instant consideration!

Pay Details: $32.00 to $44.00 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance