Reimbursement Business Manager - Southern New England - Boston, MA

Providence, RI, United States
Apr 23, 2019
Required Education
Bachelors Degree
Position Type
Full time
Known for its scientific and operational excellence, Regeneron is a leading science-based biopharmaceutical company that discovers, invents, develops, manufactures, and commercializes medicines for the treatment of serious medical conditions. Regeneron commercializes medicines for eye diseases, high LDL-cholesterol, atopic dermatitis and a rare inflammatory condition and has product candidates in development in other areas of high unmet medical need, including rheumatoid arthritis, asthma, pain, cancer and infectious diseases.

Reimbursement Business Manager reports to the Director, Field Access & Reimbursement. This position is a critical front-line member of the Regeneron Field Reimbursement team. The primary purpose of this role is to provide expertise in reimbursement to all Regeneron customers, both internal and external. This position will support physician offices throughout all facets of the reimbursement cycle and work with government, state and commercial payers to ensure the lines of communication remain open for existing and future Regeneron products. This position seeks to fully understand provider business drivers and will help develop compliant approaches to account issues and management.


• 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 proven competencies which will assist healthcare professionals in resolving reimbursement issues/barriers in a manner that complies with Regeneron policies, processes, and standard operating procedures.

• 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.

• 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.

• Meet or exceed the standard level of performance in target account activity.

• Demonstrate territory planning and time management skills by effectively covering the specific geographical area of responsibility.

• Work effectively within a team-focused organization.

• 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.

• Proactively work toward the identification of payer trends, policies and changes through payer, provider and field collaboration.

• 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.


• Bachelor's degree from a four-year college or university.

• 5-8 year's pharmaceutical/biotech/device industry experience, including minimum of 3-5 years healthcare coverage, coding and/or reimbursement experience.

• 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.

• Experience with implementing and executing Medicare, Medicaid, and Managed Care Payer initiatives.

• Proven expertise in supporting healthcare provider offices with coding, billing and submissions in range of payer environments.

• Familiarity with processes of CPT, HCPCS, ICD-9, revenue codes and DRG, coverage and reimbursement.

• Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur.

• Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies.

• Knowledge of government, state and commercial insurance systems, methodology, and reimbursement policies and processes.

• Ability to accommodate 50-70% travel.

• Candidate must reside within assigned territory.

This is an opportunity to join our select team that is already leading the way in the Pharmaceutical/Biotech industry. Apply today and learn more about Regeneron's unwavering commitment to combining good science & good business.

To all agencies: Please, no phone calls or emails to any employee of Regeneron about this opening. All resumes submitted by search firms/employment agencies to any employee at Regeneron via-email, the internet or in any form and/or method will be deemed the sole property of Regeneron, unless such search firms/employment agencies were engaged by Regeneron for this position and a valid agreement with Regeneron is in place. In the event a candidate who was submitted outside of the Regeneron agency engagement process is hired, no fee or payment of any kind will be paid.

Regeneron is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.