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

Role Summary

The Field Reimbursement Manager is a critical front-line member of the Regeneron Ophthalmology Field team. 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. You will develop compliant approaches to account issues and management by understanding provider business drivers.

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/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’s 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 using company-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 office, hospital, HOPD or ASC).
• 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.
• Familiarity with health insurance claim forms including UB-04, CMS-1500, explanations of benefits, prior authorization forms, and related documentation to troubleshoot billing and claims issues.
• Ability to analyze and interpret regulatory and legislative payer and healthcare policies.
• Bachelor’s degree.
• 5–8 years of pharmaceutical/biotech/device experience, including 3–5 years of healthcare coverage, coding, and/or reimbursement experience; experience with Specialty Pharmacy network products.

Education

• Bachelor’s degree

Skills

• Coverage and coding knowledge for Regeneron products
• Regulatory and policy interpretation
• Effective communication with healthcare providers and internal teams
• Account planning and time management

Additional Requirements

• Residence within the assigned territory and ability to travel 50–70% of the time.