Virtual Reimbursement Field Manager (VFRM)

Job Description or Purpose

The Virtual Reimbursement Field Manager (VFRM) is responsible for providing reimbursement and patient access support to healthcare providers and their staff through virtual engagement. This role serves as a key resource for billing, coding, payer coverage, and buy-and-bill reimbursement processes while helping resolve access and reimbursement challenges. The VFRM works closely with Sales, Market Access, and Patient Services teams to support healthcare providers, improve patient access, and ensure a high level of customer service and compliance.

Core Responsibilities

• Conduct virtual outreach and engagement with healthcare providers, hospitals, physician offices, and reimbursement teams to provide education and support related to patient access and reimbursement.
• Serve as a subject matter expert on reimbursement, billing, coding, J-codes, and buy-and-bill processes for pharmaceutical products.
• Educate and onboard healthcare providers and office staff on billing procedures, coding requirements, and national and local payer coverage policies.
• Support commercial and Medicaid payer initiatives, including coverage education and reimbursement-related activities, in collaboration with Market Access leadership.
• Serve as a primary point of contact for reimbursement questions, helping identify and resolve coverage, billing, and patient access challenges in a timely manner.
• Review and interpret benefit verification requests and results to identify reimbursement barriers and support appropriate resolution.
• Collaborate with Sales, Market Access, and Patient Services teams to coordinate customer support, communicate reimbursement updates, and improve the overall patient experience.
• Maintain consistent virtual engagement with approximately 10–15 healthcare offices or facilities daily to support product procurement, billing, coding, and reimbursement.
• Ensure all activities are conducted professionally and in accordance with company policies, industry regulations, and compliance requirements.
  

Requirements

• Bachelor's degree in Business, Health Sciences, Healthcare Administration, Management, or a related field; advanced degree (MBA or MS) preferred.
• 3+ years of experience in the biotechnology, pharmaceutical, medical device, or healthcare industry.
• 3+ years of hands-on experience in reimbursement, billing, and coding within healthcare, biotechnology, pharmaceuticals, wound care, or surgical devices.
• Strong knowledge of healthcare reimbursement practices, medical terminology, billing procedures, coding, payer coverage policies, and compliance requirements.
• Demonstrated experience supporting healthcare providers with buy-and-bill processes, including purchasing and billing pharmaceutical products under J-codes.
• Experience launching new biologics or innovative therapies involving medical and pharmacy benefits.
• Experience in reimbursement or account management within biotechnology, particularly dermatology and buy-and-bill products, preferred.
• Experience working directly with commercial and Medicaid payers preferred.
• Certified Professional Coder (CPC) certification preferred.
• Strong communication, problem-solving, and relationship management skills with the ability to effectively engage healthcare providers and internal teams in a virtual environment.
• Ability to work independently, manage multiple priorities, and resolve reimbursement and patient access challenges while maintaining a patient-first approach.

At TJP, we are dedicated to creating an inclusive and welcoming environment for all. We believe in equal opportunity for everyone and are committed to treating all applicants and employees fairly, regardless of race, color, religion, creed, national origin, ancestry, sex, age, disability, military status, genetic information, sexual orientation, or any other characteristic protected by law at the federal, state, or local level. If you need assistance with the application process or require accommodations, please don’t hesitate to reach out to us—we are here to help. 

 

No recruiting or staffing agency inquiries, please.