Field Reimbursement Manager-Ophthalmology – Seattle, WA (PNW) & Portland, OR

Role Summary

The Field Reimbursement Manager (FRM) for Ophthalmology supports physician offices through all facets of the reimbursement cycle and maintains open communication for Regeneron products. The role focuses on understanding provider business drivers to develop compliant approaches to account issues and management.

Responsibilities

• Develop and execute account plans that build reimbursement confidence with customers (e.g. MD and staff) and support continued patient access.
• Proactively educate accounts on support services to ensure patient access to care and monitor the impact of these services and their interaction with providers.
• Develop collaborative relationships with Regeneron colleagues to educate physician offices in coverage and coding of Regeneron products and support patient access to care.
• Guide healthcare professionals in resolving reimbursement issues or barriers in a manner that follows Regeneron policies and processes.
• Anticipate and adapt to the customer‚Äôs needs, as well as market changes and challenges.
• Demonstrate proactive planning and time management by efficiently covering the assigned RBM Territory.
• Establish positive working relationships with accounts and effectively manage product concerns.
• Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes and utilize approved access materials to support reimbursement confidence.

Qualifications

• Previous experience working with billing and medical claims personnel in various health care settings (e.g., physician offices, hospitals, HOPDs, or ASCs).
• Expertise in supporting healthcare provider offices with coding, billing, and submissions across payer environments; experience with Medicare, Medicaid, and other payer initiatives.
• Familiarity with CPT, HCPCS, ICD-10, revenue codes, DRG, and coverage.
• Experience with health insurance claim forms (UB-04, CMS-1500), explanations of benefits, prior authorization forms, and supporting documentation to troubleshoot billing and claims issues.
• Ability to analyze and interpret regulatory and legislative payer and healthcare policies.

Education

• Bachelor's degree required.

Additional Requirements

• Candidate must reside within the assigned territory and have the ability to travel 50%‚Äì70% of the time.