Reimbursement Business Advisor - Glaucoma (MidAtlantic)

WV, United States
Nov 21, 2020
Required Education
Bachelors Degree
Position Type
Full time
About AbbVie
AbbVie's mission is to discover and deliver innovative medicines that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas: immunology, oncology, neuroscience, eye care, virology, women's health and gastroenterology, in addition to products and services across its Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at . Follow @abbvie on Twitter , Facebook , Instagram , YouTube and LinkedIn .

The primary function of the Reimbursement Business Advisor (RBA) is to work with health care provider accounts and facilities to support patient access for Eye Care reimbursed products. The RBA does this through 1) product-specific provider reimbursement support, 2) coordination of HUB reimbursement services, and 3) managing payer/coverage pull-through initiatives.

The RBA is responsible for managing an assigned territory and providing product reimbursement assistance and approved support tools and resources to health care providers in physician practices and surgical facilities. The RBA helps health care providers and support staff work through reimbursement barriers and understand the payer landscape. The RBA provides this help and support while focusing on streamlining the use of specific products with appropriate patients for FDA-approved and FDA-cleared indications. The RBA must have a solid working knowledge of buy-and-bill and medical device reimbursement, as well as a clear understanding of Medicare, Medicare Advantage, Commercial, and Medicaid insurance plans and benefit design.

The RBA must work effectively with multiple key stakeholders (sales, marketing, managed markets, compliance, legal, and regulatory) in a matrixed environment to achieve targeted MBOs and meet established KPIs. The RBA is expected to be a subject matter expert on reimbursement processes (i.e., benefit verification, prior authorization, claim assistance, and appeals) and knowledgeable of current eye care market dynamics. In addition, the RBA needs to build and maintain strong relationships with health care provider practices and facilities, while implementing and managing field reimbursement responsibilities. The RBA role includes a great deal of travel, and requires a high degree of communication, account coordination and cross-functional collaboration.

The RBA must conduct all work activities in compliance with all internal requirements and meet all applicable business, compliance, legal, and regulatory requirements.



• Bachelor's degree, MBA desirable

• Health care credentialing and/or certification desirable

• In-depth and current knowledge of today's health care environment, specifically buy-and-bill and medical device reimbursement
• Minimum of 5-7 years of proven success in a health care related field
• Reimbursement-related experience in two or more of the following areas:
o Medical device reimbursement
o Physician-administered injectables
o CPT III and/or Miscellaneous J-code reimbursement
o Product launch
• Strong medical reimbursement experience with HUB reimbursement services and specialty pharmacy distribution
• Experience with benefit verifications, prior authorizations, claim assistance, and appeals
• Payer/insurance coverage experience with Medicare, Medicare Advantage, Commercial and Medicaid plans

Job Type


Equal Employment Opportunity
At AbbVie, we value bringing together individuals from diverse backgrounds to develop new and innovative solutions for patients. As an equal opportunity employer we do not discriminate on the basis of race, color, religion, national origin, age, sex (including pregnancy), physical or mental disability, medical condition, genetic information gender identity or expression, sexual orientation, marital status, protected veteran status, or any other legally protected characteristic.