Field Reimbursement Specialist

Field Reimbursement Specialist

The Field Reimbursement Specialist (FRS) will be responsible for the management of defined accounts in a specified geographic region in the ophthalmic 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 knowledgeable of and have had experience with patient health information (PHI).

• Act as an extension of the product providing live one‑on‑one coverage support.
• Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms.
• Reviewing patient‑specific information in cases where the site has specifically requested the assistance in resolving any issues or coverage challenges.
• Reviewing patient insurance benefit options.
• Identifying alternate funding/financial assistance programs.
• Coordinating with our client’s patient support services programs representatives.
• Educating physician office staff on the use of our client’s patient assistance and call center support services, including web‑based provider programs.
• Provide information on relevant reimbursement topics related to our client’s products.
• Serve as payer expert for defined geography and able to communicate changes to key stakeholders in a timely manner.
• Provide office support in accurate coding and billing for the client’s products.

• Minimum two years’ of access and reimbursement, managed care, and/or billing and coding support experience
• Experience working with Buy and Bill products and a thorough understanding of the entire reimbursement process from script to injection required
• Ophthalmic, retina specialists and biosimilar experience preferred
• Experience establishing relationships within a practice by working closely to help remove reimbursement barriers to specialty products for their patients
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus
• Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems a plus
• Ability to travel and cover large multistate geography territories, 50% travel required
• Excellent presentation and project management skills

The annual base salary for this position ranges from $155,000k to $160,000k. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate’s qualifications, skills, competencies, and proficiency for the role. In addition, some positions may include eligibility to earn commissions/bonus based on company and / or individual performance.

Syneos Health has a voluntary COVID‑19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality‑of‑life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time.

Because certain states and municipalities have regulated paid sick time…