Manager, Field Outsourcing Job in Los Angeles, California US

Work Location:

 Los Angeles or San Francisco

Shifts:

 Not Applicable

Positions Available:

 1

Position Summary

Xcenda, a business unit of AmerisourceBergen Consulting Services, is an integrated, world-class consulting organization focused on value, reimbursement and patient access. Our company brings together a team of exceptional healthcare and business professionals whose multidisciplinary experience fulfills an unmet need in the marketplace. We provide customized solutions and innovative approaches that discover and communicate the value of pharmaceuticals and other healthcare technologies. We are leaders and innovators—uncompromising in our determination to uncover hidden insights and shatter previous limitations.

Xcenda currently provides health care reimbursement teams for several pharmaceutical and biopharmaceutical clients. These teams are responsible for providing field support for patient access to our client’s products through interaction with the client’s reimbursement support program. These reimbursement specialists provide their expertise and experience to help resolve patient access issues and to provide educational services within a physician office environment. Reimbursement specialists work directly with prescribers and their office support staff and commonly interact with other reimbursement and patient support services provided by our clients.

Xcenda has been given a wonderful opportunity to partner with several new clients for supporting the launch phase of new physician administered drugs. Xcenda is currently recruiting for reimbursement specialists positions and have many exciting opportunities. Xcenda will not pay relocation expenses for these positions.

Primary Duties and Responsibilities

Reimbursement specialists 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 reimbursement support services offered by our clients. Activities include, but are not limited to:

· Reviewing patient insurance benefit options

· Validating prior authorization requirements

· Identifying alternate funding/financial assistance programs

· Reviewing appropriate billing and coding for products

· Assisting with resolving reimbursement issues

· Coordinating with our client’s patient support services programs representatives.

· Educating physician office staff on the use of our client’s patient assistance and Lash Group reimbursement support services, including web based provider programs

Providing information on relevant reimbursement topics related to our client’s products.

Experience and Education Requirements

· Bachelor’s degree, advanced degree or specific practice management experience preferred

· Minimum two years experience in public or private third party reimbursement arena or practice management including the revenue cycle or pharmaceutical industry experience focused on reimbursement

· Public speaking experience preferred

· An ability to effectively interact with physicians and their staff

· Technical knowledge of health care reimbursement from a patient and provider perspective (miscellaneous J codes, billing, coding, appeals process)

· Knowledge of private payer, Medicare and Medicaid structure, systems, and reimbursement process

· Ability to analyze and interpret regulation and legislation

· Demonstrated teamwork abilities

· Project management skills

· Ability to work independently

· Ability to travel overnight for three to four nights per week

· Ability to manage expenses within allocated budgets

· Good driving record and comfortable driving rental cars

· Ability to drive during the daytime and nighttime

· Live within 45 minute drive of major airport

· Ability to utilize own car for travel (mileage reimbursed)

· Ability to schedule individual work related travel(air, hotel, rental car as needed)

· Above average computer skills: PowerPoint, Excel, Word

This position may require credentialing for specific facilities. This process includes passing limited medical examinations and may include some vaccinations and document review.

 

Minimum Skills, Knowledge and Ability Requirements

Three skills critical to being successful in this position include:

· General payer policy knowledge including managed care and Medicare/Medicaid

· Foundational knowledge of benefit verifications and prior authorization requirements

· Knowledge of reimbursement processes within the physician office

Specific knowledge of local payer policies related to a specific client product will be acquired during training sessions.

All interactions with allied health professionals require detailed attention to customer needs and satisfaction. And most importantly, all reimbursement activities are required to be conducted and managed within all appropriate legal and regulatory guidelines and require continuous monitoring of compliance with such guidelines and laws.

Additional Information


Job Code : HRReq009599
Division/Department : AmerisourceBergen Corporation