Field Reimbursement Manager – Ophthalmology

• Develop and execute account plans that build reimbursement confidence with customers (e. g. MD and staff) & support continued patient access
• Proactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers
• Develop collaborative relationships with Regeneron colleagues (ex.

Regional Directors and Medical Specialists) to educate physician offices in coverage/coding of Regeneron products and support patient access to care

• Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes
• Anticipate and adapt to the customer’s needs, as well as market changes and challenges
• Demonstrate proactive planning and time management skills by the efficient and effective coverage of your assigned FRM Territory
• Establish positive working relationships with accounts (e. g. MD’s, Administrators & office staff) and effectively manage product concerns
• Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize basket of company approved access materials to support reimbursement confidence

Requirements

• Bachelor's degree from a four-year college or university
• 5-8 years' pharmaceutical/biotech/device experience, including minimum of 3-5 years healthcare coverage, coding and/or reimbursement experience
• Previous experience working with billing and medical claims personnel in various health care settings, including, but not limited to a physician office, hospital, HOPD or 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
• Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets 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
• Candidate must reside within assigned territory and have ability to travel 50%-70% of the time
• Core Competencies

Demonstrates expertise in healthcare coverage, coding, and reimbursement processes, with a strong ability to build relationships with healthcare professionals and navigate payer environments.

Proficient in analyzing regulatory policies and effectively managing patient access to care.

• Highest-signal resume keywords
• Healthcare Coverage Expertise
• Reimbursement Experience
• Coding and Billing Knowledge
• Relationship Management
• Regulatory Analysis
• ATS Optimization Keywords
• Hard Skills
• Healthcare Coverage
• Coding
• Billing
• Reimbursement
• Payer Initiatives
• Medicare
• Medicaid
• Claims Submission
• Regulatory Policies
• Healthcare Policies
• Soft Skills
• Proactive Planning
• Time Management
• Adaptability
• Communication
• Collaboration
• Industry Keywords
• Pharmaceutical
• Biotech
• Device
• Healthcare Provider
• Patient Access
• Tools & Technologies
• Explanation of Benefits
• Prior Authorization Forms
• Super Bills
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