The Field Reimbursement Manager (FRM) is a regionally aligned, field-based position that provides access and reimbursement education and support for customers that utilize DEXTENZA® from Ocular Therapeutix. Customers will include Healthcare Providers (HCPs) and staff within offices, ambulatory surgery centers (ASCs), hospital outpatient departments (HOPDs), and other appropriate site-of-care facilities. The FRM will work closely with internal/external stakeholders including HCPs, billing and coding staff, revenue cycle managers and other professionals involved in securing appropriate Access & Reimbursement for the use of DEXTENZA®.
The FRM provides support through (1) product-specific provider reimbursement support, (2) coordination of HUB reimbursement services, and (3) managing payer/coverage pull-through initiatives. The FRM must have a solid working knowledge of buy-and-bill products with Medical (Part-B) reimbursement, as well as a clear understanding of all Public and Private insurance plans and benefit design. Additionally, the candidate should have a working knowledge of the “Medicare Pass-Through” program.
The FRM is expected to be a subject matter expert on access & reimbursement processes for a product with a permanent J Code and paid by the Medical benefit (i.e., pass-through, benefit verification, claim assistance, and appeals). In addition, the FRM needs to build and maintain strong relationships with provider practices and facilities, while implementing and managing field reimbursement responsibilities. The FRM role includes a high degree of communication, account coordination and cross-functional collaboration.
Internal and External Contacts:
The FRM must work effectively with multiple internal & external stakeholders in a matrix environment to achieve target objectives and meet established MBO’s/goals.
Internal: Field Sales, Managed Markets, Marketing, other Patient Services teams (including outsourced HUB services), and MSL (as needed)
External: HCPs, HOPDs, ASCs, pharmacy, and billing/coding staff associated with key customers