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Adecco is currently assisting one of its clients in their search for a Field Reimbursement Manager to work remotely from the Midwest territory.

**Pay rate** : $55.00 – $60.00 per hour

**Shift availability** : Monday – Friday 8am – 5pm (may vary)

**Location** : Remote

**Territory:** Kansas, Missouri, Indiana or Michigan (must live 1 hour from a major airport)

For instant consideration for this role, click on Apply Now and don’t forget to upload your resume!

The Field Reimbursement Manager (FRM) plays a critical role in facilitating patient access to therapy by navigating complex reimbursement landscapes.

Operating within a designated territory, the FRM provides expert guidance on benefit investigations, prior authorizations, claims resolution, and appeals.

This client- and customer-facing role requires strong relationship-building skills with healthcare providers and manufacturer partners.

The FRM delivers tailored education and support both virtually and on-site, ensuring optimal utilization of reimbursement services.

This position demands a high level of autonomy, strategic thinking, and collaboration with internal hub services to meet evolving customer needs.

Therapeutic Space – i.e. Cardiovascular Disease Therapy

Key Responsibilities

+ 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. These activities are recorded in FRM CRM daily with reporting to manager weekly. 35%

+ 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. This trended data is also reported quarterly to client. 25%

+ 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. These interactions are tracked in FRM CRM and hub system. 20%

+ 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. All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client. 10%

+ 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. Additionally, clients have the option to survey customers on program performance. 10%

Minimum Job Qualifications Education/Training:

• 4-year degree

• Must have strong background in prior authorizations and appeals support

• Minimum of 8 years healthcare related reimbursement experience

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

• Experience supporting program specific drug therapy space, i.e., oncology, dermatology, etc.

• 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. Specialized

Knowledge/Skills:

• Previous field experience, a plus

• Previous experience with specialty pharmacy a plus

• Account management experience, a plus

• Excellent Interpersonal skills.

• Excellent written and oral communication skills.

• Problem solving and decision-making skills.

Working Conditions:

• General Office Demands – Remote, WFH Travel Requirements:

• Must reside in territory.

• Must be able to travel 80% (4 days a week) via automobile or plane. Confidentiality Notice: This document, including any attachments, is for the sole use of its intended recipients and may contain confidential, Work Instructions

• Must have a valid driver's license with a clean driving record/ MVR. Physical Requirements **:**

• Possible long periods of sitting and/or keyboard work. General office demands.

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 the role **,** APPLY NOW for instant consideration!

**Pay Details:** $55.00 to $60.00 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

Military connected talent encouraged to apply

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://uat.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

**Massachusetts Candidates Only:** It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.