Role summarythe field reimbursement manager, eye care (frm) acts as an alternative in-office resource that is available to address hcp questions about patient access.
the frm calls directly on hcp offices in their assigned, specific geography to answer questions about patient access and reimbursement in support of eye care.
the frm provides expertise on coverage and common access and reimbursement challenges affecting the eye care portfolio of buy and bill products.
the frm responsibilities include educating on the access and reimbursement support tools available from abbvie, advising hcps on patient prescription status and program eligibility, and educating hcp offices on payer processes and procedures.responsibilitieseducate hcps on patient support programs, including access and reimbursement support tools and serviceseducate on product-specific acquisition and access options such as specialty pharmacy networks, specialty distribution, and white-bagging supporteducate on resources available to address access issuesprovide local expertise in regards to national/regional payor policies in order to educate providers on payer issues, coding changes, and appropriate claims submission processesliaise with abbvie's access and reimbursement support center to update hcps on rx status and program eligibilityreport back payer trends related for approved products to patient services and market access account management teamsestablish and maintain relationships with appropriate providers within territoryremain current on key managed care, reimbursement, and policy activitiesqualificationsat least 3 years of experience in buy and bill access and reimbursement, payer account management, and/or market accessthorough understanding of the technical payer policy processes, systems and requirements for coverage, coding and payment for specialty medicinesdemonstrated understanding of the rules, regulations and risks associated with provision of reimbursement support servicesstrong understanding and ability to communicate technical elements of coding and billing requirements at the national and regional level across all settings of carecomprehensive understanding of parts a, b, c and d or medicare and associated reimbursement dynamicsstrong understanding of drug acquisition and dispensing in the eye care space (buy and bill, specialty pharmacies, specialty distributors, etc.)strong understanding of access and reimbursement support service centers and how to effectively interact in a compliant fashionexcellent territory and account management skillsbachelor's degreedriving a personal auto or company car or truck, or a powered piece of material handling equipmentvalid driver's license: ability to pass a pre-employment drug screening test and meet safe driving requirements.an essential requirement of your position is to satisfy all applicable health care industry representative (hcir) credentialing requirements to gain and maintain entry into facilities and organizations that are in your assigned territory.
you must also be in good standing and/or eligible to obtain these credentials.these hcir credentialing requirements may include, but are not limited to, background checks, drug screens, proof of immunization/vaccination for various diseases, fingerprinting and specific licenses required by individual state or cities.
you are solely responsible for ensuring that you satisfy all hcir credentialing requirements and for any associated liability.additional requirementshcir credentialing requirements may include background checks, drug screens, immunization proofs, fingerprinting, and state/city licenses; ensure compliance for entry into facilities in the assigned territory.
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