Reimbursement Business Manager, Ophthalmology (MS, AL, LA)

Birmingham, AL, United States
Oct 15, 2020
Required Education
Bachelors Degree
Position Type
Full time
The Reimbursement Business Manager is a critical front-line member of the Regeneron Ophthalmology Field team. You will use your expertise and knowledge with all Regeneron customers, both internal and external. In this role, you will support physician offices throughout all facets of the reimbursement cycle and work to ensure the lines of communication remain open for existing and future Regeneron products. We always do what is right and seek to fully understand provider business drivers to help develop compliant approaches to account issues and management. This role covers 3 states: Alabama, Mississippi and Louisiana, and the candidate must live within the geography. Birmingham AL or New Orleans preferred.

In a typical day, you will:
• Develop an encouraging and collaborative relationship with Regeneron colleagues (Regional Directors and Medical Specialists) to educate physician offices in coverage, coding of Regeneron products.
• Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes.
• Through your interaction with clients, you anticipate and adapt to the customer's needs, as well as market changes and challenges.
• Cultivate relationships with targeted government, state and commercial payers designed to improve support for Regeneron products within a compliant framework, which is needed to support the ongoing requirements.
• Demonstrate territory planning and time management skills by efficient covering of the specific geographical area of responsibility.
• Work with 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 advice on claims appeals and process changes.
• Proactively work toward the identification of payer trends, policies and changes through payer, provider and field teamwork.
• Actively monitor and identify reimbursement requirements and environmental / policy changes set forth by government, federal and managed care organizations.

This role might be for you if you possess the following:
• Bachelor's degree from a four-year college or university.
• 5-8 years' pharmaceutical/biotech/device 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.
• Shown expertise in supporting healthcare provider offices with coding, billing and submissions in range of payer environments. Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives.
• We expect you to be familiar with CPT, HCPCS, ICD-9, revenue codes and DRG, coverage.
• 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.
• Candidate must reside within assigned territory, and have the ability to travel 50-70%

Does this sound like you? Apply now to take your first steps toward living the Regeneron Way! We have an inclusive and diverse culture that provides amazing benefits including health and wellness programs, fitness centers and stock for employees at all levels!

Regeneron is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion or belief (or lack thereof), sex, nationality, national or ethnic origin, civil status, age, citizenship status, membership of the Traveler community, sexual orientation, disability, genetic information, familial status, marital or registered civil partnership status, pregnancy or maternity status, gender identity, gender reassignment, military or veteran status, or any other protected characteristic in accordance with applicable laws and regulations. We will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application process. Please contact us to discuss any accommodations you think you may need.