Virtual Field Reimbursement Specialist

Description Are you a skilled facilitator adept at building connections and driving communication? As a Virtual Field Reimbursement Specialist, you will manage designated accounts within a specific region, executing strategic plans in collaboration with internal teams and external partners. This role requires you to be a reimbursement subject matter expert and provide comprehensive office education throughout the entire reimbursement process, including formulary coverage, insurance forms, benefits investigation, prior authorization, appeals, and claims resolution. Core Responsibilities include: Act as the primary virtual reimbursement point of contact for assigned accounts, addressing reimbursement inquiries promptly. Become a payer expert, effectively interpreting and communicating changes in payer policies for Medicare, Medicaid, and Commercial plans to key stakeholders. Educate and assist prescribing physicians and their support staff on reimbursement, coding, and patient access issues, including: Benefit verification results Prior authorization requirements Appeals processes Claims submission and denial troubleshooting Site of Care considerations (Buy and Bill) CPT, HCPCS/J-codes, ICD-10, and diagnosis codes Support claims issue resolution, addressing underpayments, denials, and documentation requests. Track payer-specific challenges, communicate access trends, and escalate complex reimbursement or policy issues as necessary. Document reimbursement cases, trends, and outcomes to identify repeating barriers to access. Manage multiple reimbursement cases simultaneously while meeting service expectations. Cross Functional Interaction: Collaborate virtually and in person as needed with internal partners to: Share insights and address recurring reimbursement challenges. Ensure consistent communication regarding access pathways. Provide timely updates on case status and resolution outcomes using approved internal tools. Engage in internal meetings and training sessions to remain informed on reimbursement strategies and product updates. The ideal candidate possesses: A BA/BS degree. 5+ years of experience in the pharmaceutical or biotech industry. 1+ years of experience in field reimbursement. A proven ability to resolve access issues within the specialty pharmacy channel. Oncology experience is advantageous but not mandatory. A willingness to travel 15% - 80% virtually with 15% for live engagements. The position offers a competitive annual base salary ranging from $145,000 to $160,000, influenced by individual qualifications and experience. Additional compensation may include performance-based bonuses. At Syneos Health, we are committed to fostering a diverse and inclusive workplace. If your background doesn’t perfectly match the job requirements, we still encourage you to apply. We value transferable skills and invite you to join our Talent Network to explore further career opportunities. Why Syneos Health? By joining our field access teams, you will collaborate with experts in the industry and gain the autonomy needed to navigate the intricate reimbursement landscape. Our diverse partnerships create numerous career paths, all aimed at advancing biopharmaceutical therapies to patients. Experience the fulfillment of knowing that your work contributes to improving lives globally. Work Here Matters Everywhere | How are you inspired to change lives? Syneos Health is an equal opportunity employer. Syneos Health has a voluntary COVID-19 vaccination policy and encourages all employees to be fully vaccinated. Certain local governments or clients may enforce specific vaccine requirements. Employees must provide proof of vaccination where applicable. We strive to create an environment that promotes growth, development, and work-life balance, offering a comprehensive benefits package that includes health coverage, 401k matching, and flexible paid time off.

Created: 2026-03-11