Job Information
Merz Pharmaceuticals LLC Reimbursement Access Manager - REIMB001097 in Philadelphia, Pennsylvania
Reimbursement Access Manager - REIMB001097
DESCRIPTION/RESPONSIBILITIES: Job Details Description * This is a remote role that requires travel near a major airport for this territory: Philadelphia, Pittsburgh, Lehigh Valley, Harrisburg, Albany NY
The Reimbursement Access Manager (RAM) requires an individual with demonstrated success in reimbursement expertise, including interpretation of coverage, coding and payment policies, with the ability to apply such knowledge at the provider level.
The RAM will be responsible for leading and overseeing all reimbursement and access functions within their assigned region. Specifically, the RAM is tasked with developing relationships with Merz customers and facilitating appropriate patient access to therapies through education and in-services to practices. The RAM will also provide highly involved and personalized guidance to the Neurosciences field staff and Merz business partners in understanding and addressing reimbursement and access challenges.
Major duties Description Account Management * Work strategically with practices to deliver information that facilitates patient access to and appropriate reimbursement of Merz Therapeutics products. * Offer resources that support the providers in gaining access to Merz Therapeutics products for their patients as appropriate. Support Benefit Verification * Review patient benefit options, prior authorization requirements and alternate funding/financial assistance programs with providers and office staff.
Adoption of HUB Services * Increase awareness and utilization of the Next Steps support line services. Leverage the program to provide high touch support to practices and patients.
Provide Coverage Landscape * Serve as a technical expert in government and third party reimbursement and coverage policies and as a source for reimbursement information for internal (Marketing, Sales, Medical Affairs, etc.) and external (Physicians, Office Staff) customers.
Current of CMS Trends * Monitor Centers for Medicare and Medicaid Services (CMS) reimbursement policies and keep abreast of trends in reimbursement and health policy that affect Merz Therapeutics' products and the markets in which they compete.
Access Issue Resolution * Communicate changes or issues relating to commercial coverage policies to the National Accounts team in a timely fashion.
Veeva Portal Input * Document all office interactions in the Veeva portal of practice interaction. The notes recorded in Veeva should be limited to basic information for follow up calls (i.e., diagnosis codes, CPT codes, reason for denial) and office contact logistics.
PSP Education * Ensure practices are aware of Patient Assistance and Patient Co-pay programs available for patients being treated. Supports patient compliance to therapy.
Education: * Bachelors Degree Required
Professional Experience : * 5 Years combined experience in billing, coding, practice management and/or pharmaceutical reimbursement support (Required) * Experience related to selling or in reimbursement of botulinum neurotoxin (Preferred) * Experience as a Reimbursement Access Manager - RAM or Field Reimbursement Manager - FRM
Knowledge, skills and abilities * Must possess the following: general payer policy knowledge (public and private payers), foundational knowledge of benefit verifications and prior authorization requirements and knowledge of reimbursement processes within various sites of care. (Required) * Excellent collaboration skills, critical thinking and a high level of competence in reimbursement (coverage, coding and payment) for pharmaceutical products (including specialty pharmaceuticals). (Required) * Successful leadership, project management and presentation skills, including proven ability to manage through a "highly matrix" environment. (Required) * Demonstrated ability to make effective decisions in a fast paced environment.(Required) * Ability to work indepen ently, manage travel schedule and make effective decisions regarding territory management (Required) * Ability to interpret and integrate business strategies into actionable patient access initiatives. (Required)
Travel This role requires the ability to travel overnight up to 3 or more nights per week.
Recruitment Note: Merz Therapeutics only sends emails from verified "merz.com" addresses and never asks for sensitive, personal information or money. If you have any doubts about the authenticity of any type of communication from, or on behalf of Merz Therapeutics, please contact Therapeutics.HR@merz.com Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Merz Therapeutics we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Equal Opportunity Employer-minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity