Expert in Retail Pharmacy and Specialty pharmacy drug Prior Authorizations, Appeals, and working denials, with experience of FRM territory management experience, training and educating provider office staff.
FIELD / TRAVEL position covering a territory: Houston, TX/New Mexico
The best FRM candidates will :
Bring FRM territory experience (including experience working without access to PHI)
Truly care about the patients and work through all roadblocks and barriers to get the medications approved and paid for.
Have expertise in : RETAIL Pharmacy, as well as, Specialty Drug Prior authorizations through portals, benefits investigations , working appeals and denials
Have LOCAL PAYOR LANDSCAPE KNOWLEDGE: Medicare & Medicaid
Know some work arounds when PHI is not accessible
Have experience in: escalations, education, Commercial co-pay card approvals , Patient Assistance program approvals , foundation coverage, guidelines, and reimbursement. Keeping up with changes and updates to drug programs, new FDA indications, miscellaneous J-codes, and payer policy changes that impact reimbursement.