Job Description

Adecco is hiring immediately for a Field Reimbursement Manager with a local client. Hybrid (must reside within 45 minutes of a major airport in the following territory Northern CA area) Apply now if you meet the qualifications listed below!

• Pay Range: $ 60.10/hr

• Shift/Hours: Mon Fri 8:00am 5:00pm (will vary)

• Hybrid, but must reside in Territory ( Northern CA )

Responsibilities:

• Provide on-site and on-demand education (including Lunch and Learns) 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 are required based on client expectations These activities are recorded and tracked for reporting purposes daily with reporting to manager weekly.

• 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.

• 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 internal and external stakeholders required to ensure timely and efficient workflow based on program service levels agreements. All interactions and activities are tracked for reporting purposes.

• 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 specified FRM CRM which are reportable to management and client.

• 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.

Requirements:

• 4-year degree in 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 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, physicians 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

• Must reside within territory and be able to travel 80% via automobile or plane.

• Must have valid DL and clean driving record/MVR

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.

Pay Details: $60.10 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

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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

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