Field Reimbursement Manager - Seattle, WA

About the role

The Field Reimbursement Manager supports the Respiratory business unit and covers Washington and Oregon. The role manages defined accounts within a geographic region for Patient Access and Reimbursement, executes the territory strategic plan and ensures understanding of the reimbursement process, field reimbursement services and patient support programs. It requires knowledge and experience with patient health information (PHI).

Key responsibilities

• Support products from physician order through reimbursement, covering payer prior authorization to appeals and denials requirements and forms.
• Resolve patient-level reimbursement issues and review patient-specific information when requested.
• Educate healthcare providers on private and public payer coverage, benefit design (commercial, Medicare, Medicaid) and payer changes.
• Coordinate access and reimbursement issues with partners, including the HUB, and act as a payer expert for the defined geography.
• Deliver office education on formulary coverage, utilization management, insurance forms, prior authorization, appeals and claims resolution.
• Review patient insurance benefit options and alternate funding or financial assistance programs.

Required profile

• Basic qualification: doctorate, or master's degree with 3 years of customer service or leadership experience, or bachelor's degree with 5 years, or associate's degree with 10 years, or high school diploma with 12 years of customer service or leadership experience.
• Must have direct people-management or team/project leadership experience.
• At least two years of experience in third-party access, managed care, clinical support or sales, and strong medical reimbursement experience or Specialty Pharmacy and Buy & Bill knowledge.
• Experience in the healthcare industry (insurance verification, claim adjudication, physician offices, pharmacies or manufacturers).
• Experience with hubs and billing, coding and appeals across physician types; experience with commercial payers, Medicare and state Medicaid in a region.
• Live in the geography or within 10 miles of its border (preferred).

Required skills

• Web-based meetings and computer literacy (Word, Excel, PowerPoint).
• Presentation, facilitation, written and oral communication, and project management.
• Preferred: CMS policies and Medicare Part B and Part D knowledge.

Working conditions

• Three days a week in the geography for customer appointments, plus one to two home-office days per week.
• Travel up to 60-80% by car or plane; valid driver's license with a clean record required.
• Relocation is not included.

What we offer

• Annual salary range (actual varies with skills, experience and qualifications).
• Health, dental, vision, life and disability insurance, retirement savings plan with company contributions, and flexible spending accounts.
• Discretionary annual bonus or sales-based incentive plan, stock-based long-term incentives and time-off plans.
• Flexible work models, including remote and hybrid arrangements where possible.