Field Reimbursement Specialist

Overview

Do you have a noticeable passion for results?

Connecting people with the information they need is your forte. You’re a unifier by nature and you’re at your best when setting others up for success. Your ability to clear the way, extrapolate intricate details, attend to complex situations and serve as a trusted go-between make you a perfect fit for a Field Reimbursement Specialist role at Syneos Health.

Responsibilities

The Field Reimbursement Specialist (FRS) will be responsible for the management of defined accounts in a specified geographic region in the Cardiac therapeutic area, specifically supporting our client’s products.

The FRS will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of Reimbursement process, field reimbursement services, and patient support program. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI).

In this role, the FRS will demonstrate unwavering support and consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients. The FRS will have a direct impact on a patient’s ability to access the therapies they need.  Additional responsibilities include:

• Manage daily activities that support appropriate patient access to our client’s products in the provider offices and work as a liaison to other patient assistance and access support services offered by our clients (i.e. HUB, Call Center, Specialty Pharmacy Services)
• Act as an extension of the call center and/or HUB and provide live one-on-one coverage support
• Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner
• Offer office education during the entire access process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or  claims resolution
• Educate offices using approved materials provided by the client
• Review patient-specific information in reimbursement cases where the office has specifically requested assistance in resolving access issue or coverage challenge
• Educate physician office staff on the use of our client’s patient support services, including web based provider portals

Job Requirements

Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:

• A Bachelor’s Degree
• Minimum three years of experience in public or private third party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
• Experience with specialty/biologic products
• Cardiology experience a plus
• Demonstrated ability to educate offices on access processes  
• Experience educating HCPs on client specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.)
• Experience delivering educational presentations
• Advanced knowledge of medical insurance terminology
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B – for buy & bill products and Part D for Pharmacy products)
• Ability to manage ambiguity & problem solve
• Ability to manage expenses within allocated budgets

Interviews may be conducted in person at an on-site interview location. For any in person interviews, local COVID-19 safety guidelines will be followed.

I understand that if I am made an offer of employment, it will be conditioned on my demonstration I am fully vaccinated OR I plan to initiate vaccination by my start date AND be fully vaccinated within 4 weeks of start date against the COVID-19 virus.


IMPORTANT: I understand that if the role for which I am applying requires extensive in-person contact with colleagues, health care providers, clients and other medical professionals who have stringent vaccination requirements that all Syneos Health employees with whom they partner be fully vaccinated and will not accept or consider any exemptions. I understand I can request an exemption from Syneos Health’s vaccination requirement based on a qualifying medical condition or sincerely held religious belief. However, in the event that I successfully obtain an exemption, I understand that it is highly unlikely that I will be able to adequately perform the essential functions of this position without imposing an undue hardship on Syneos Health due to the clients’ demands.

About Syneos Health Syneos Health^® (Nasdaq:SYNH) is the only fully integrated biopharmaceutical solutions organization purpose-built to accelerate customer success. We lead with a product development mindset, strategically blending clinical development, medical affairs and commercial capabilities to address modern market realities.

To learn more about how we are Shortening the distance from lab to life^®, visit syneoshealth.com or subscribe to our podcast.

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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled