Reimbursement Manager Resume Sample
Delbert Glover
26551 Destinee Trail,
Los Angeles,
CA
+1 (555) 219 1839
Work Experience
Field Reimbursement Manager
03/2017
-
PRESENT
Philadelphia, PA
- Oversee the planning, development and coordination of the preparation and documentation of Medicare, Medicaid, OSHPD and other external cost reports as appropriate for assigned facilities; help ensure adherence to all third-party reporting requirements
- Suggest improvements to current processes to ensure compliance with regulations as well as efficiency of data gathering
- Coordinate the support for governmental and financial audits of cost reports and other analyses for third-party filings; help ensure the accurate settlement of all issues. Support the Reimbursement Specialist(s) by providing guidance on dealing with fiscal intermediaries during the audit process
- Oversee the preparation of appeals and re-openings of cost reports and supporting analyses for assigned facilities; help ensure the accurate and timely settlement of all issues. Support the Reimbursement Specialist(s) (if any) in their efforts with researching and writing appeals
- Prepare and support the calculation of revenue deductions, contractual allowances and other reserves and settlement accounts for assigned facilities; help ensure the accuracy of monthly and annual financial reporting
- Establish and maintain courteous and cooperative relationships with internal and external contacts, both suppliers and users of departmental data; help ensure open channels of communication
- Maintain current knowledge of system operations, federal and state regulations, impacting the various external cost reporting requirements; help ensure MHS compliance with applicable laws
- Prepare impact analysis of changes in regulations and be able to communicate these changes to hospital
- Orient new Reimbursement Specialists to the workflow of the department and act as a mentor to ensure their professional growth
Reimbursement Manager
06/2013
-
09/2016
Detroit, MI
- Provide input for CATs of Reimbursement Specialists as applicable
- Microsoft Access experience desirable
- Participate in interviewing prospective employees, evaluating current employees, and train employees as needed. Work to develop employee’s supervisory skills and provide direction to supervisory staff concerning performance management issues and corrective disciplinary actions
- Oversee the planning, development and coordination of the preparation and documentation of Medicare, Medicaid, OSHPD and other external cost reports as appropriate for assigned facilities; help ensure adherence to all third-party reporting requirements. Suggest improvements to current processes to ensure compliance with regulations as well as efficiency of data gathering
- Assists in developing, recommending, and implementing programs and objectives to achieve business goals and for achieving account success in TRICARE/VA/TPharm/DoD payors
- Facilitate daily revenue cycle specific needs and communication between the company and the FHS payors
- Facilitate oversight and activity for the daily resolution of FHS account denials
- Interact with department directors in key pharmacy areas to obtain necessary documentation to support services provided, in order to clear denials
- Investigate denial trends and initiate communication with root cause owners and action owners to prevent future claim edits, denials, and report these issues in timely manner to leadership
Regional Reimbursement Manager
11/2010
-
01/2013
Boston, MA
- Participate in internal system wide revenue cycle meetings designed to improve revenue cycle process
- Support the National Director FHS with specific DoD revenue analysis and metrics
- Analyze and make recommendations to all revenue cycle in regards to Federal Health Services
- Lead project initiatives to implement new processes or modifications to existing processes that result in timely revenue resolution
- Collect, aggregate and analyze data from multiple sources to facilitate identification of trends, interdependencies and root causes
- Design and develop dashboards and reporting that deliver meaningful and accurate conclusions from the monitoring efforts
- Examination of aged, outstanding revenue to determine best course of action resulting in resolution
- Create and maintain Federal Health Services payors contractual requirements and reimbursement criteria
- Perform QA of all revenue cycle functions on a consistent basis and to compile recommendations for improvement
Education
Strayer University - Delaware County Campus
2005 - 2010
Bachelor's Degree in Accounting
Professional Skills
- Strong interpersonal skills; excellent communication skills
- Strong organizational skills. Demonstrated analytical skills
- Demonstrated analytical, problem solving, and relationship-building skills
- Demonstrated problem solving and decision-making skills with the ability to “think on his or her feet” and suggest alternatives and solutions
- Knowledge of customer-focused selling skills
- Demonstrated ability to plan, organize and prioritize work responsibilities
- Above average computer skills: PowerPoint Excel Word
How to write Reimbursement Manager Resume
Reimbursement Manager role is responsible for organizational, analytical, presentation, interpersonal, microsoft, software, business, research, reporting, computer.
To write great resume for reimbursement manager job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Reimbursement Manager Resume
The section contact information is important in your reimbursement manager resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Reimbursement Manager Resume
The section work experience is an essential part of your reimbursement manager resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous reimbursement manager responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular reimbursement manager position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Reimbursement Manager resume experience can include:
- Strong communication skills; ability to effectively interact with physicians and their staff
- Demonstrated analytical, negotiation, problem solving, and relationship-building skills
- Working Effectively with Others (builds rapport, collaboration and teamwork, org savvy, energizing and engaging
- Planning, organizing and territory management skills
- Validating prior authorization requirements
- Demonstrated ability and capacity to successfully negotiate and manage competing priorities
Education on a Reimbursement Manager Resume
Make sure to make education a priority on your reimbursement manager resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your reimbursement manager experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Reimbursement Manager Resume
When listing skills on your reimbursement manager resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical reimbursement manager skills:
- Hands–on operational reimbursement experience – in-house and outsourced experience desirable
- Good driving record; Ability to drive during the day and night
- Have a valid driver's license and a safe driving record and be available to drive during the day and nighttime
- Experience with research and analysis, relationship-building (with clients and/or customers) and public speaking
- Have a valid driver's license and a safe driving record and be availale to drive during the day and nighttime
- Demonstrate excellence in meeting and exceeding customer expectations especially in difficult situations
List of Typical Experience For a Reimbursement Manager Resume
1
Experience For Field Reimbursement Manager Resume
- Develops and manages effective strategies to increase/optimize reimbursement and/or market access for all devices
- Reviewing appropriate billing and coding for products
- Facilitating live training and education (group sizes vary)
- Assisting with resolving reimbursement issues
- Interacting with key stake holders within the physician practice or hospital outpatient location
- Coordinating with our client’s patient support services programs representatives
2
Experience For Access & Reimbursement Manager Resume
- Providing information on relevant reimbursement topics related to our client’s products
- Interacting with key stake holders within the specialty practice or hospital outpatient locations
- Educating physician office staff on the use of our client’s patient assistance and
- Provide training when needed for quality improvement and stay abreast of all Federal payor regulations
- Responsible for development and execution of coding, coverage and payment strategies
- Communicate appropriate changes that need to occur due to these regulations
- Establishes and maintains positive and productive work relationships with all staff and customers and serves as the go-to resource for FHS BioScrip reimbursement and operations teams questions related to collections, reimbursement and general contractual questions
- Assists in developing solutions to client problems, and coordinates efforts of various departments.Acts as advisor to program team regarding projects, tasks, and operations
- Parts of New England
3
Experience For Regional Reimbursement Manager Resume
- Develops, implements, monitors, and defends best in class reimbursement strategies in support of all major marketed and pipeline devices
- Leads and aligns the reimbursement and health policy function to deliver on Company’s objectives
- Understands policies, educates internal management teams, and develops strategic objectives for addressing major changes in the US (Affordable Care Act) and global healthcare environment
- Drive adoption of quality measures and clinical guidelines that can support reimbursement strategies
- Conduct field visits with sales team members to understand the business and educate teams on managed care topics/issues
- Serves on Edit Administration Committee to approve and advise edit requests for Health System
- Building models based on changes in reimbursement methodologies to determine financial impact to the System. This requires independent research and command of where to obtain the correct information
4
Experience For Access & Reimbursement Manager, Sleep Resume
- Support business-planning processes, the development of annual operating and capital budgets, accounting related business processes, financial reporting, decision support and cost accounting, regulatory filing or other similar finance and accounting related activities
- Prepare Medicare Cost reports
- Handle audits of cost reports with the Medicare Intermediary
- Educating physician office staff on the use of our client’s patient assistance and reimbursement support line services including web based provider programs
- Reimbursement support services including web based provider programs
- Support management of the Home Injection Training Services, Patient Assistance Program, and Co-pay Assistance Program
- Execute reimbursement initiatives to increase awareness of the reimbursement system Mallinckrodt has established and ensure patients have access to Acthar in a timely manner
- Support RDSS department’s role as a central resource to commercial operations (sales, marketing & analytics) and corporate staff for reimbursement and distribution issues and for their ongoing development of this knowledge base in those areas
5
Experience For Access & Reimbursement Manager, Pain Resume
- Professionally represent manufacturer’s patient and physician access services
- Provide information on relevant access topics related to client’s products
- Devise and implement customer specific pre and post call promotional approaches that evaluate and address the practitioners' perspectives and the institutions philosophies within compliance guidelines
- Develop infusion capabilities in local targeted marketplaces
- Implement our clients patient and practice support hub in all called on practices, work to reduce barriers to access for patients and providers
- Consistently use approved marketing aids to support the case for the brand value proposition when selling. Position and adapt the message to meet the practitioner's, institutions, and company's objectives
- Develop and execute on comprehensive business plan that includes but not limited to opportunities and challenges in local market, key strategies and tactics to drive the business, maximization of resources available as well partnership with key business partners and stakeholders in order to drive sales in local geography
- Works with billing and payment posting management to obtain optimal results in process improvement
- Develop a territory coverage plan that maximizes selling time with all account professionals. Institute strategies to increase access to all key stakeholders
6
Experience For Reimbursement Manager Neo Resume
- Develop and apply knowledge of payer access and affordability landscape in the territory regarding the company's products
- Recommends improvements in billing process, and follows up on unpaid or underpaid accounts
- Maximize and customize the value proposition and access strategies within the assigned institutions and practices
- Devise and institute an integrated business plan that includes clear strategies and tactics to target key accounts utilizing all available resources, while aligning the plan with the region, and company's goals
- Cross-functionally partner with all client field personnel
- Utilize business analytics to recognize territory opportunities, strengths, and trends, and to monitor the effectiveness of the business plan. Adjust the plan to minimize the impact of competition and to maximize sales opportunities
- We have a strong culture around our mission of Complete Stroke Care which aims to reverse the trend of 120,000 – a staggering 1 in 20 -- US deaths caused by nearly 800,000 US strokes per year
- We are the market leader in cutting edge, less invasive neurotechnologies that not only demonstrated improved patient outcomes in five recent Class I, Level A evidence stentriever trials, but also drove Stryker’s overall business growth
7
Experience For Immunology Field Reimbursement Manager Resume
- We were recently recognized in 2015 as at Top Work Place in the Bay Area by the Bay Area News Group
- Coordinate with Salix’s patient support services programs representatives on patient cases and claim issues
- Educate office staff on the use of Salix’s patient assistance and reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant reimbursement topics related to Salix’s products
- Company-wide liaison with Third Party Hub Service Provider(s) and Salix customers
- Internal Contacts: Daily interaction with appropriate Sales Force and leadership, Key Account Managers (KAMs), Managed Markets Account Managers, and direct manager
- Support access at the provider level for Makena by providing timely and appropriate information related to coverage, coding, and payment policies across all payers relevant to a provider’s payer landscape. This includes
- Understand and be able to translate access trends and policies to assist AMAG’s efforts to address non-clinical barriers to Makena therapy
- Anticipate changing payer landscape by demonstrating a deep understanding and knowledge of public payer emerging trends that can impact access for Sun’s branded products and pipeline
- Serve as the team’s primary point of contact with strategic business units and customers
8
Experience For Div Inst Reimbursement Manager Resume
- Manages and coordinates the filing and resolution of underpaid and/or unpaid claims of one or more specialties related to the third party, government and/or patient billing for professional healthcare services
- Develop, evaluate, implement and maintain policies and procedures to ensure quality with billing practices maximize reimbursement of physician services while complying with all applicable government and other regulatory agencies
- Monitors reimbursement patterns of contracted and non-contracted carriers, including government agencies, notifying management of major, unresolved problems
- Consistently reviews account receivable reports and additional financial data to identify potential trends and issues
- Monitor accounts receivable and collections to ensure collections and DSO goals are achieved
- Monitors and completes adjustments and transfers to ensure correct reimbursement
9
Experience For Senior Reimbursement Manager Resume
- Obtains and maintains a working knowledge of reimbursement guidelines of third party and private insurance payers and government regulations in all states where services are provided, and maintains a current working knowledge of CPT/ICD-9 coding regulations as set forth by all related government and regulatory agencies
- Assist in managed markets training and development of the OAM’s
- Execute reimbursement initiatives to increase awareness of the reimbursement system Questcor has established and ensure patients have access to Acthar in a timely manner
- As a Subject Matter Expert for Reimbursement, develop a supportive and collaborative relationship with Regeneron colleagues (Regional Directors and Medical Specialists) to educate physician offices in coverage, coding and reimbursement of Regeneron products
- Develop ongoing interaction with clients, one that anticipates and adapts to the customer’s reimbursement and support needs, as well as market changes and challenges
- Work toward the establishment of relationships with targeted government, state and commercial payers designed to enhance support for Regeneron products within a compliant framework, which is needed to support the ongoing requirements of reimbursement
10
Experience For Access Reimbursement Manager, Baltimore Resume
- Complete assigned individual development goals, territory business plan, reporting activities, expense reports and other requirements as requested by Field Reimbursement leadership in a timely fashion
- Work effectively within a team-focused organization
- Meet or exceed the standard level of performance in target account activity
- Collaborate with various departments and individuals at Regeneron to effectively facilitate, implement and execute the overall divisional and corporate goals and objectives. Work cross-functionally on RBM commercial liaison projects
- Work with Field Reimbursement leadership to monitor and track the impact of Eylea4U and its interaction with provider offices and its services offered to providers
- Establish positive work relationships with office managers and staff to identify claims concerns and coding issues, while providing guidance on claims appeals and process changes
List of Typical Skills For a Reimbursement Manager Resume
1
Skills For Field Reimbursement Manager Resume
- Proven teamwork and collaboration skills with a demonstrated track record of working in highly matrixed and cross-functional work teams
- Demonstrated problem solving and decision-making skills with the ability to “think on his/her feet” and suggest alternatives and solutions
- Solid understanding of reimbursement fundamentals including coding, coverage and payment
- Strong knowledge and understanding of managed care: commercial payers, Medicare (including Part D and Low Income Subsidy), Medicaid and Specialty Pharmacy
- Good driving record; Ability to drive during the daytime and nighttime
2
Skills For Access & Reimbursement Manager Resume
- Experience with coding, billing and in office support programs
- Experience training and managing staff
- Solid understanding of coverage policy creation, interpretation and management
- Experience in oncology and working with key oncology stakeholders
- Healthcare coverage, coding and/or reimbursement experience
- Previous experience working with vendor relationships desirable
- Previous experience managing customer interactions
- Work experience conducting site visits, audio conferences, and presentations
3
Skills For Regional Reimbursement Manager Resume
- Strong knowledge base in healthcare policy, reimbursement, market access, pharmaceutical or biotechnology sales or marketing, or similar industry
- Experience with specialty providers in support of reimbursement
- Excellent ability to communicate with patients, their relatives, physicians, and a variety of Agency personnel
- Demonstrated ability to handle multiple tasks concurrently
- MBA, CPA & three years of leadership experience
- Experience with reimbursement
- Liaising with reimbursement hotlines regarding alternative funding/financial assistance programs
- Communicating with Impact (influencing, listening and receptivity, candid and direct communication)
- Educating provider offices on local and regional payer issues, coding changes, and appropriate claims submission processes
4
Skills For Access & Reimbursement Manager, Sleep Resume
- Assisting with determining coverage and access options available for a specific medication or procedure
- Overseeing operations for the areas of responsibility which includes the following
- Understanding of coverage, coding (diagnostic, procedural and product), payment and reimbursement requirements and policies
- Establishing relationships within a practice by working closely with them to help remove Reimbursement barriers to specialty products for their patients
- Understanding of patient privacy laws including HIPAA and similar state laws
- Providing face-to-face, personalized issue resolution
- Working knowledge of insurance collections. Ability to supervise a staff
- Working with a Patient Service Center/Hub in order to design case-specific strategies based on payer mix, benefit design, and authorization requirements
5
Skills For Access & Reimbursement Manager, Pain Resume
- Business Acumen (strategic thinking/planning, analyzing/diagnosing, external perspective, accelerating change)
- Provides assistance and training to faculty and staff on coding, compliance, and billing issues
- Assists in the selection, training, orienting and assisting department staff. Develops standards of performance, evaluates performance and
- Proficient knowledge of FHS line of business medical claims, electronic billing, and PBM claims processing systems
- Knowledgeable on Medicare billing/coding and appeal process. ASP, WAC as well as Sequestration; interpret and understand Medicare EOBs and CMS 1500 forms
- Technical knowledge of health care reimbursement from a patient and provider perspective (miscellaneous J codes, billing coding, appeals process)
- Medical coding credentials / Certified Professional Coder (CPC)
6
Skills For Reimbursement Manager Neo Resume
- Develop and update content in keeping with client requests and needs
- Maintains up to date professional knowledge of TRICARE, VA, Express Scripts and DHA policies and requirements for qualifying services
- Knowledge of pertinent Federal, State, and local laws, codes, and regulations related to patient billing and collection
- Comfortable working in a transparent environment (fair balance, full disclosure, Safe Harbors, etc.)
- Hands-on attitude, highly willing to roll up own sleeves to get activities done
- Contribute to RFP’s on reimbursement requirements working with a cross-functional team to coordinate activities and achieve departmental goals
- Possess expertise in and deep understanding of specialty pharmacy
- Conduct policy surveillance across regional MACs to ensure appropriate coding, coverage, and payment of Valeant products
7
Skills For Immunology Field Reimbursement Manager Resume
- Navigates the complex regional payer landscape for OBU therapies; identify issues and facilitate problem-solving process
- Stable, growing organization
- Systemic understanding of the global payer and distribution environment, in particular, biologic In-Office Injectables (IOI) in the U.S
- Enjoys supporting end users
- Travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory / targeting make up
- Live within a reasonable driving distance from a major airport. Up to 80% travel is required
- 401K + Company Matching
8
Skills For Div Inst Reimbursement Manager Resume
- Conduct policy surveillance across regional MACs to ensure appropriate coding, coverage, and payment of Bausch Health products
- Provide internal and external customers with accurate and timely data to support strategic decision-making and compliance
- Maintain knowledge of industry/payer standards and regulations as they relate to billing and collection of accounts receivable
- Short & Long-Term Disability Insurance
- Life & Supplemental Life Insurance
- Territory Includes: Wisconsin, Minnesota, Iowa, North Dakota and South Dakota
- Experience in a related field, including Medical Device and/or Drugs / Biologicals industry, Insurance industry, Healthcare Reimbursement Services, Medical Coding, Billing and/or Medical Claims Processing
9
Skills For Senior Reimbursement Manager Resume
- Previous experience working with Sales, Marketing, Clinical, Regulatory, and Research & Development teams to support product launches and educate sales staff and external customers on current and future product coding and reimbursement
- Experience with Tissue Matrices / Skin Substitutes used in the wound care and surgical interventions
- Microsoft Office/Suite proficient (Excel, Outlook, PowerPoint Word, etc.)
- Acquires and maintains thorough knowledge of federal and state legislative and administrative action affecting physician and professional provider reimbursement; disseminates acquired knowledge to faculty and staff
- Coordinate all aspects of Medicare and Medicaid cost reporting and related activities, including filings, audits appeals, and reopenings. Prepare HCFA 855 and other certification forms as required. Assign tasks, direct and review work of other staff to ensure that all requirements are completed on an accurate and timely basis
- Technical knowledge of health care reimbursement from a patient and provider perspective (authorizations, miscellaneous J codes, billing coding, appeals process)
- Live within 45 minutes of a major airport in the designated territory and be able to travel extensively (overnight - 80% of the time) within that territory
- Knowledge of private payer, Medicare and Medicaid structure systems and reimbursement process
10
Skills For Access Reimbursement Manager, Baltimore Resume
- Live within 45 minutes of a major airport in the New York metropolitan area and be able to travel extensively (overnight - 80% of the time) within a designated territory which includes but is not limited to New York
- Live within 45 minutes of a major airport in the Albany or Syracuse metropolitan areas and be able to travel extensively (overnight - 80% of the time) within a designated territory which includes but is not limited to Albany or Syracuse
- Live within 45 minutes of a major airport in the posted location and be able to travel extensively (overnight - 80% of the time) within an assigned territory
- Live within 45 minutes of a major airport in the posted location and be able to travel extensively (overnight - 80% of the time) within a designated territory
- Live within 45 minutes of a major airport in the Boise metropolitan area and be able to travel extensively (overnight - 80% of the time) within a designated territory which includes but is not limited to Boise
- Provide education to customers on the reimbursement process, including coding and reimbursement support or responding to customer questions or concerns regarding reimbursement for the GI portfolio
- Presentation of reimbursement information such as proformas and economic models to financial decision makers and purchasers
- Work with physician champions and professional societies to secure adequate reimbursement of procedures
List of Typical Responsibilities For a Reimbursement Manager Resume
1
Responsibilities For Field Reimbursement Manager Resume
- Demonstrated analytical skills, ability to work independently, and strong organizational skills
- Strong organizational skills and demonstrated analytical skills
- Demonstrated leadership skills and ability to lead without authority with internal and external
- Effectively address customer concerns in a timely fashion and work collaboratively with external and internal stakeholders
- Possess the leadership ability to effectively organize, communicate and direct people
- Demonstrated work ethic and integrity
- Previous sales management and/or account management experience highly desirable
- Significant sales experience in the biologic (injectable) market
2
Responsibilities For Access & Reimbursement Manager Resume
- Possesses relevant work experience to conduct site visits, audio conferences and give presentations
- Highly organized with an ability to prioritize and deliver high quality, accurate work within the required timeline for self and others
- Able to operate with significant autonomy; self-starter
- Experience in Allergy Therapeutics is helpful
- Relevant and direct experience
- Provide direct support to prescribing physicians and support staff regarding reimbursement, coding and patient access issues
- Provides support and calculation for valuation of accounts receivable within the Revenue Cycle Analytics tool including actual, budgeted and projected amounts
- Proactively work toward the identification of payer trends, policies and changes through payer, provider and field collaboration
3
Responsibilities For Regional Reimbursement Manager Resume
- Actively monitor and identify reimbursement requirements and environmental / policy changes set forth by government, federal and managed care organizations; whether those changes effect Regeneron or targeted healthcare provider offices
- 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
- Familiarity with processes of CPT, HCPCS, ICD-9, revenue codes and DRG, coverage and reimbursement
- Knowledge of government, state and commercial insurance systems, methodology, and reimbursement policies and processes
- Accommodate 50-70% travel
- Develops, implements, and maintains systems related to the calculation of third party reimbursement
- Works collaboratively with other departments and ministries within their Region related to net revenue management activities
- Prepares annual Medicare and Medicaid hospital cost reports and provides support upon audit
4
Responsibilities For Access & Reimbursement Manager, Sleep Resume
- Performs the calculations of accounts receivable valuation in Crowe RCA and also evaluates monthly settlements of third-party reimbursement in addition to filing annual Medicare and Medicaid cost reports
- Develops, implements and maintains systems related to the calculation of third party reimbursement
- Critical point person for all reimbursement and acquisition logistical aspects of a high touch biologic medication for an orphan disease, and testosterone products with multiple acquisition options within a changing payer landscape
- Incorporate knowledge of dynamic and complex marketplace and business trends to deliver maximum access to the portfolio of Jazz products
- Develop and maintain a relevant network of key Payer accounts, Medicare agencies (MACs) and Workers Comp Organizations
- Anticipate changing payer landscape by demonstrating a deep understanding and knowledge of public payer emerging trends that can impact access for Jazz products and pipeline
- Manage and develop administrative C-level relationships with relevant personnel at assigned Integrated Delivery Networks (IDNs) and specialty pharmacy accounts (as needed) within defined geographical region of the US
- Provide compliant support and education to assigned customer accounts and networks for activities related to appropriate patient access to Jazz products
5
Responsibilities For Access & Reimbursement Manager, Pain Resume
- Collaborate with other Access and Reimbursement Managers (ARMs) and the Patient Services HUB team to resolve or prevent account issues related to proper coding, billing, denials, and revenue recovery related to product coverage and reimbursement
- Collaborate with Account Management, Patient Support Services, and HUB vendor teams on specific Payer issues
- Effectively and compliantly communicate issue resolution updates to the Jazz Market Access and Field Sales organization, as well as to key external stakeholders
- Ensure compliant processes are in place to drive clear communication with Jazz field teams to ensure clarity of reimbursement issues and opportunities and support pull-through efforts
- As needed, conduct regional business reviews and updates with assigned regional sales and cross-functional team(s), within compliance guidelines
- Participate in teleconference and live National, regional and district meetings and training sessions; represent Jazz at national and/or local conventions when requested
- Demonstrated effective account management and strong customer service skills
6
Responsibilities For Reimbursement Manager Neo Resume
- Coordinate with Valeant Pharmaceuticals, Inc. patient support services programs representatives on patient cases and claim issues
- Educate office staff on the use of Valeant Pharmaceuticals, Inc. patient assistance and reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant reimbursement topics related to Valeant Pharmaceuticals, Inc. products
- Provide information on relevant Reimbursement topics related to the product
- Analyze Data and develop Action Steps
- Meet and exceed the FRM team objectives
- Meet and exceed the OBU objectives
- Strong collaboration and communication with local market unit (Zone Director, Region Director, Sales Representatives, Key Account Managers, Market Access partners) to develop action plans to prioritize business and reimbursement needs, identify key FRM accounts, and to establish and maintain the team communication plan and pathway
- Proactively seek and reactively respond to identified coverage, access and reimbursement issues and challenges
7
Responsibilities For Immunology Field Reimbursement Manager Resume
- Strategic agility – Links responsibilities with the mission of the organization
- Provides information on access requirement and processes, coverage and policy updates and patient resources to external customers
- Work is from home. No office is provided by company
- South Los Angeles, Orange County
- San Diego, CA and Phoenix area
- Raleigh, Charlotte, Winston-Salem area
- Long Island, Queens area
8
Responsibilities For Div Inst Reimbursement Manager Resume
- Review Medicare and Medicaid developments on an ongoing basis to remain current in the field, and to ensure that the Health System understands the impact of new regulations on its business and takes appropriate action. This requires constant research and knowledge of services and operations and significant analytical and communication skills
- Coordinate in the planning, directing, and managing external audits, resolves audit issues and responds to inquiries from external auditors, such as Medicare, Medicaid, State auditors
- Responsible for preparation of Medicare and Medicaid monthly contractual and settlement account estimates
- Acts a conduit between the Field and Home Office Genentech functions for all public and private payer policies and practices that impact patient access to Genentech products
- Teamwork and Collaboration – Creates and atmosphere of openness and truest’ collaborates; offers support and encouragement
- Travel required - up to 50%
9
Responsibilities For Senior Reimbursement Manager Resume
- Specific knowledge of specialty pharmacy and provider interactions required
- Knowledge of private payer Medicare and Medicaid structure systems and reimbursement process
- Manage expenses within allocated budgets (Company Credit Card for approved travel expenses and related charges)
- Live within 45 minute drive of major airport (No relocation assistance is available)
- Schedule individual work related travel (air hotel rental car as needed)
- Specific knowledge of specialty pharmacy/buy and bill and provider interactions required
- Successful navigation of complex authorization processes for specialty medications
- Field responsibilities that include supporting and educating HCP offices on best practices that streamline the authorization process and expedite treatment access for patients
10
Responsibilities For Access Reimbursement Manager, Baltimore Resume
- Experience in the healthcare industry including, but not limited to pharmaceutical sales, insurance verification and/or claim adjudication (in physician’s office, surgical center or pharmacy and/or pharmaceutical manufacturers)
- Knowledge / expertise in Local Coverage Determinations (LCDs) per each regional MAC for all ENDO products
- Understands the legislative, legal and regulatory environments and anticipates potential impact to Endo
- Synthesize clinical literature and target product profile in order to understand implications for value to payers, patients and health care providers and Endo
- Strong written and verbal communication skills, with an ability to condense complex information into concise outputs and direction
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• Tighter controls around achievement of our cost targets
• Appropriate resource allocation decisions are made
• Better governance of RtB resources used to support our CtB programmes
• Identification and assignment of roles and responsibilities across all...
Professional Skills
• Demonstrated strong writing, editing and c...
• Build productive relationships at all leve...
• Build productive relationships at all leve...
Banking Executive Resume Sample
Work Experience
• Composes letters and memoranda from verbal direction or knowledge of bank’s policies, procedures, and functions. Initiates responses to correspondence for senior executive or own signature
• Builds and manages a high performing team of directors, analyst and digital product management professionals...
Professional Skills
• Able to demonstrate broad experience of de...
• Up to 3 years' experience within financial...
• Thorough knowledge of general office proce...