Specialist, Access and Reimbursement
AbbVie
11 days ago
Remote friendly (North Chicago, IL)
United States
$65,500 - $125,500 USD yearly
Market Access
Responsibilities:
- Collaborate with Field Reimbursement Managers (FRMs) and Health Care Providers (HCPs) in designated territories to enhance patient access and support positive health outcomes.
- Educate FRMs and HCPs on patient support programs, including tools and services for access and reimbursement; share resources to resolve patient access challenges.
- Provide local expertise on plans and educate on prior authorization, medical exception, and appeal processes for inbound and outbound calls.
- Develop and sustain relationships with relevant providers in the territory; communicate clearly and efficiently with FRMs, HCPs, and stakeholders.
- Own process improvement initiatives to enhance system efficiencies and patient access strategies.
- Maintain knowledge of business procedures, deviations, and case processing for brands and channel sources, as needed.
- Use critical thinking to assess and prioritize workloads at the account level.
- Monitor and streamline communication between stakeholders to improve efficiency and reduce redundancies.
- Meet department performance standards; maintain required privacy standards and comply with required training, laws, SPII policies, and procedures of Complete Patient Access and AbbVie.
Qualifications:
- Bachelor’s or Associate degree in health sciences or business preferred; comparable/relevant experience considered.
- 3–5 years healthcare industry experience with knowledge of reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations.
- Demonstrated understanding of rules/regulations and risks for reimbursement support services; technical knowledge of coverage, coding, payment, and distribution of specialty products.
- Strong knowledge of access and reimbursement support service centers; ability to interact compliantly.
- Thorough understanding of technical payer policy processes, systems, and requirements for coverage.
- Professional written and verbal communication skills; maintain a positive service image with challenging issues and unsatisfied customers.
- Collaborate with Field Reimbursement Managers (FRMs) and Health Care Providers (HCPs) in designated territories to enhance patient access and support positive health outcomes.
- Educate FRMs and HCPs on patient support programs, including tools and services for access and reimbursement; share resources to resolve patient access challenges.
- Provide local expertise on plans and educate on prior authorization, medical exception, and appeal processes for inbound and outbound calls.
- Develop and sustain relationships with relevant providers in the territory; communicate clearly and efficiently with FRMs, HCPs, and stakeholders.
- Own process improvement initiatives to enhance system efficiencies and patient access strategies.
- Maintain knowledge of business procedures, deviations, and case processing for brands and channel sources, as needed.
- Use critical thinking to assess and prioritize workloads at the account level.
- Monitor and streamline communication between stakeholders to improve efficiency and reduce redundancies.
- Meet department performance standards; maintain required privacy standards and comply with required training, laws, SPII policies, and procedures of Complete Patient Access and AbbVie.
Qualifications:
- Bachelor’s or Associate degree in health sciences or business preferred; comparable/relevant experience considered.
- 3–5 years healthcare industry experience with knowledge of reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations.
- Demonstrated understanding of rules/regulations and risks for reimbursement support services; technical knowledge of coverage, coding, payment, and distribution of specialty products.
- Strong knowledge of access and reimbursement support service centers; ability to interact compliantly.
- Thorough understanding of technical payer policy processes, systems, and requirements for coverage.
- Professional written and verbal communication skills; maintain a positive service image with challenging issues and unsatisfied customers.