Remote Claims Processor Jobs in Katy, TX (NOW HIRING)

Key Responsibilities:

• Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staffin order tosupport integration of those products into office processes and workflows.

• Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers)in order toappropriately support patient access to products.

• Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and provide support on reimbursement issues with third party payers at the provider-level. Analyze account reimbursement issues (as needed).

• Supports pullthrough onlocal coverage decisions to enable meaningful patient access within the system.Proactively communicate policy changes or issues that could potentially affect other departments.

• Maintainexpertisein regional and local access landscape,anticipatingchanges in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed).

• Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, andappropriate officestaff education.

• Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.

• Responsible for educating HCPs using approved materialsregardingacquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.

Buy and Bill Specific

• Assessaccesssituation within the assigned geography and developappropriatePlan of Action (POA).Communicate POA toappropriate personnel.

• Responsible for educating HCPs using approved materialsregardingacquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.

• Educates relevant stakeholders onlogisticsrelated to ordering, payment, inventory, and product returns & replacement.

• Analyze reimbursement issues,anticipatingchanges in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.

• Accountable for engagement with non-prescribersin regards toNovartis medicines, for example pharmacy, system leadership, financial counselors, office administrators, revenue cycle managers, etc.

• Education:Bachelor's Degreerequired.Business and/or biological science education preferred. Advanced degree preferred.

• 5+ Years of experience in pharmaceuticals / biotech industry focusedinPatient Services, Market Access, Sales, and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s).

• Experience working withhighly complexpractices and/or health systems toestablishaccess and acquisition pathways.

• Strategic account management experienceusinga proactive approach toanticipateaccess hurdlesimpactingaccounts and patient access.

• Deepexpertiseand experience integrating manufacturer-sponsored patient support programs.

• Experience with specialty productsacquiredthrough Specialty Pharmacynetworks.

• Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail).

• Candidate mustresidewithin territory, or within a reasonable daily commuting distance of60miles from the territory border.Abilityto travel 60-80% over a broad geography isrequired, with the ability to drive and/or fly within the territory.Musthave a valid driver's license.