Field Reimbursement Manager

Summary

Join Coherus BioSciences as a Field Reimbursement Manager and play a crucial role in optimizing patient access to oncology products. You will work to minimize reimbursement barriers by collaborating with providers and patients, offering education and support on Coherus reimbursement programs. Responsibilities include addressing complex patient access issues, educating facility staff on policies, and conducting claim reviews. This field-based position requires extensive experience in the pharmaceutical or biotech industry, specifically in healthcare coverage, coding, and reimbursement. A Bachelor's degree and strong understanding of payer policies are essential. The role involves significant travel within the assigned territory.

Requirements

• 5+ years of commercial experience in the pharmaceutical or biotech industry
• 3+ years of experience in healthcare coverage, coding and/or reimbursement
• Direct experience with Buy and Bill products, Medicare Part B and Miscellaneous J-Codes required
• Bachelor's degree from a four-year college or university
• Previous experience working with billing and medical claims personnel in various health care settings, including physician office, hospital, HOPD and ASC
• Shown expertise in supporting healthcare provider offices with coding, billing, and submissions in range of payer environments
• Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives
• Familiar with CPT, HCPCS, ICD-10 revenue codes
• Familiarity with health insurance claim forms, explanation of benefits, prior authorization forms, and EMR/Practice Mgmt. systems, to troubleshoot cases where billing, claims submission or documentation errors may occur
• Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies

Responsibilities

• Partner with internal and external stakeholders to identify, anticipate and address patient and practice reimbursement issues
• Collaborate with Field Sales to identify facilities and practices that need reimbursement education and support regarding Coherus products
• Provide insights and updates regarding product and support service integration at accounts
• Educate facility staff on policies related to product acquisition, inventory management, and all payer polices related to support full integration of product into the practice workflow
• Provide coverage, coding, and reimbursement information to key staff members (i.e., practice administrators, reimbursement staff, and providers) in order to appropriately support patient access
• Collaborate with field facing “One Team” to compliantly share insights into customer needs, potential barriers, and payer issues/opportunities for access at practices
• Communicate and explain payer policy updates or system changes that impact access
• Proactively communicate Coherus COMPLETE™ so that office staff is fluent in how to use patient access programs and services
• Address questions associated with patient coverage, access, and reimbursement from accounts in collaboration and coordination with patient services as directed by policy and procedure
• Conduct frequent claim reviews with practices to ensure appropriate reimbursement of Coherus products
• Maintain a deep understanding of Coherus policies and requirements and perform the role in a compliant manner consistent with company guidance
• Keep abreast of customer and market access industry trends

Preferred Qualifications

Oncology experience strongly preferred

Benefits

The Base Salary Range for this position is $165,000 to $190,000